Distribution and Basic Hematological Parameters of Acute Leukemia (Myeloid & Lymphoid Type) in Thamar City, Yemen

Background: Acute hyper leucocytic leukemia (AHL) is a commonly occurred type of acute leukemia that represent a special variant in acute leukemia. Laboratory evidence of acute hyper leucocytic leukemia requires particular attention with special care in the diagnosis and treatment.

Objectives: The aim of this study is to identify changes in several basic hematological parameters in patients with acute leukemia. Also assess hematologic parameters in patients with acute leukemia with and without laboratory evidence of leukocytosis.

Materials and Methods: A total of 113 patients with newly diagnosed acute leukemia were included. Diagnosis was based on criteria for leukemic cells found in both blood and bone marrow samples.

Results: Of the total 113 patients studied, 72 (63.7%) were male, 41 (36.3%) were female, and (61.1%) patients had ALL [50 (72.5%) children and 19 (27.5%) adults] and (38.9%) had AML, [15 (34%) children and 29 (66%) adults]. The mean age of acute leukemia patients in this study was 17.2±15.3 years. The mean age of ALL patients ranged from 12.1±11.8 years and that of AML patients ranged from 25.1±16.8 years. Leukopenia was seen in (10.6%) patients and neutropenia in (71.7%) patients. Leukemic cells were present in the peripheral blood of patients (58.4%), and the other (27%) patients had the leukemic subtype. There was a statistically significant difference in total white blood cell count (P. value=0.03) following anemia severity for hemoglobin concentration (P. value =0.007). A statistically significant (P. value = 0.019) lower hemoglobin concentration was detected in patients with leukocytosis than in patients without leukocytosis. AML patient had lower hemoglobin concentrations than those with ALL types identified (P. value = 0.03). There was a statistically significant (P. value=0.0001) direct relationship between total white blood cell count and absolute peripheral blood blast cell count, and there is a significant relationship between total white blood cell count and absolute neutrophil count (P. value=0.0001).

Conclusions: AHL has lower hemoglobin concentrations compared to patients with acute leukemia without leukocytosis and affects younger age groups than adult patients. AHL occurs more frequently in the myeloid than in the lymphoblastic leukemia type and more frequently in the monocyte subtype. The main form of anemia is (mild to moderate normochromic-normocytic anemia).