Common Presenting Signs and Symptoms in Children with Acute Lymphoblastic Leukemia
-
Ehsan Shahverdi
,
Mehdi Shahriari
,
Soonia Zare
,
Mohammad Saeid Rahiminejad
,
Fatemeh Hosseinpour Soleimani
,
Massoumeh Maki
,
Rojen Manouchehri
,
Mourad Haj Abdo
Abstract
Background: Acute lymphoblastic leukemia (ALL) is one of the blood cancers responsible for 80% of children’s leukemia and is also the most common malignancy in patients aged under 14 years (frequency of 23% among all types of cancers). Regarding the importance of identifying clinical symptoms to diagnose the disease in the early stages, this study is conducted to investigate the symptoms at diagnosis in ALL children. Methods: In this retrospective cohort study, 350 patients aged under 14, referring to four hospitals of Shiraz University of Medical Sciences as reference hospitals in Southern Iran, participated between 2013 and 2019. Their information was collected using patients’ records, and the data were analyzed using SPSS version16. Results: Based on the findings of this study, the first clinical manifestations of the disease happened suddenly and acute, occurring within a few days to a maximum of 6 weeks before diagnosis. Fever (70%) and hepatomegaly (60%) were the most common signs and symptoms in patients. However, a significant percentage of ALL patients referred with non-specific symptoms. Conclusion: The results of this study indicate the importance of recognizing common and unusual signs and symptoms based on a complete and thorough history taking and accurate physical examination as well as rare symptoms that may be ignored or misdiagnosed by physicians. The knowledge of common signs and symptoms results in early diagnosis of the disease in early stages.
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Palonosetron for the prevention of nausea and vomiting in children with acute lymphoblastic leukemia treated with high dose methotrexate. Pediatric blood & cancer.
2012;59(5):870-3.
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28. Rives S EJ, Camós M, García-Miguel P, Verdeguer A, Couselo JM, Tasso M, Molina J,
Gómez P, Fernández-Delgado R, Navajas A, Badell I; grupo cooperativo SHOP (Sociedad Española de Hemato-Oncología Pediátrica). [T-cell pediatric acute lymphoblastic leukemia: analysis of survival and prognostic factors in 4 consecutive protocols of the Spanish cooperative study group SHOP]. Med Clin (Barc). 2012;139(4):141-9.
29. Saison J, Berger F, Lebosse F, Audoual R, Thomas X, Michallet M. Hepatomegaly and fever at the time of neutrophil recovery revealing L-asparaginase toxicity in the treatment of acute lymphoblastic leukemia. The American journal of case reports. 2014;15:13.
30. Ozsoylu S, Hiçsönmez G, Koçak N, Zamani V. Isolated splenomegaly during remission in childhood acute lymphoblastic leukemia. The Turkish journal of pediatrics. 1984;27(4):219-23.
31. Friedman A, Schauer P, Mertelsmann R, Cirrincione C, Thaler H, Dufour P, et al. The significance of splenomegaly in 101 adults with acute lymphoblastic leukemia (ALL) at presentation and during remission. Blood. 1981;57(4):798-801.
32. Simone JV, Verzosa MS, Rudy JA. Initial features and prognosis in 363 children with acute lymphocytic leukemia. Cancer. 1975;36(6):2099-108.
2. Amori N, Aghajani M, Asgarian F, Jazayeri M. Epidemiology and trend of common cancers in Iran (2004–2008). European journal of cancer care. 2017;26(5).
3. Chiaretti S, Zini G, Bassan R. Diagnosis and subclassification of acute lymphoblastic leukemia. Mediterranean journal of hematology and infectious diseases. 2014;6(1).
4. Pui C-H. Recent research advances in childhood acute lymphoblastic leukemia. Journal of the Formosan Medical Association. 2010;109(11):777-87.
5. Armstrong SA, Look AT. Molecular genetics of acute lymphoblastic leukemia. Journal of Clinical Oncology. 2005;23(26):6306-15.
6. Richardson RB. Promotional etiology for common childhood acute lymphoblastic leukemia: the infective lymphoid recovery hypothesis. Leukemia research. 2011;35(11): 1425-31.
7. Hjalgrim LL, Rostgaard K, Schmiegelow K, Söderhäll S, Kolmannskog S, Vettenranta K, et al. Age-and sex-specific incidence of childhood leukemia by immunophenotype in the Nordic countries. Journal of the National Cancer Institute. 2003;95(20):1539-44.
8. Whitlock JA. Down syndrome and acute lymphoblastic leukaemia. British journal of haematology. 2006;135(5):595-602.
9. Shih TY, Wu J, Muo CS, Kao CH. Association between leukaemia and X-ray in children: A nationwide study. Journal of paediatrics and child health. 2014;50(8):615-8. 10. Stepina V, Gurtsevich V, Morozova L, Etkin A, Urazova L. Human acute lymphoblastic leukemia associated with HTLV-I virus and its infection in healthy populations from various regions of the USSR. Eksperimental'naia onkologiia. 1987;9(3): 32-3.
11. Conter V, Aric M, Basso G, Biondi A, Barisone E, Messina C, et al. Long-term results of the Italian Association of Pediatric Hematology and Oncology (AIEOP) Studies 82, 87, 88, 91 and 95 for childhood acute lymphoblastic leukemia. Leukemia. 2010;24(2):255-64.
12. Castro-Jiménez MÁ, Rueda-Arenas E, Daladier Cabrera-Rodríguez M. Approach to prediagnostic clinical semiology, noticed by mothers, of childhood acute lymphoblastic leukemia. Arch Argent Pediatr. 2015;113(4):331-6.
13. Amanda Ibagy DBS, Jackline Seiben, Ana P.F.F. Winneshoffer, Tatiana E.J.B. Costa, Juliana S. Dacoregio, Imaruí Costa, Daniel Faraco. Acute lymphoblastic leukemia in infants: 20 years of experience. Jornal de Pediatria. 2013;89(1):64-9.
14. Steele M, Narendran A. Mechanisms of defective erythropoiesis and anemia in pediatric acute lymphoblastic leukemia (ALL). Annals of hematology. 2012;91(10):1513-8.
15. Barbui T, Finazzi G, Falanga A, Battista R, Bassan R. Bleeding and thrombosis in acute lymphoblastic leukemia. Leukemia & lymphoma. 1993;11(sup2):43-7.
16. Gorosquieta A, Pérez EE, Gastearena J. Asymptomatic pathological rupture of the spleen as the presenting form of acute lymphoblastic leukemia. Sangre. 1996;41(3):261.
17. Patiroglu T, Unal E, Karakukcu M, Ozdemir MA, Tucer B, Yikilmaz A, et al. Multiple fungal brain abscesses in a child with acute lymphoblastic leukemia. Mycopathologia. 2012;174(5-6):505-9.
18. Levy JMM, Hunger SP. Brain size and neuropsychological functioning in long-term survivors of pediatric acute lymphoblastic leukemia. Translational pediatrics. 2013;2(4): 140.
19. Nadaraja S, Mamoudou AD, Thomassen H, Wehner PS, Rosthoej S, Schroeder H.
Palonosetron for the prevention of nausea and vomiting in children with acute lymphoblastic leukemia treated with high dose methotrexate. Pediatric blood & cancer.
2012;59(5):870-3.
20. O’Connor D, Bate J, Wade R, Clack R, Dhir S, Hough R, et al. Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths on UKALL2003. Blood. 2014;124(7):1056-61.
21. Graubner UB, Porzig S, Jorch N, Kolb R, Wessalowski R, Escherich G, et al. Impact of reduction of therapy on infectious complications in childhood acute lymphoblastic leukemia. Pediatric blood & cancer. 2008;50(2):259-63.
22. Alados J, Cobo F, Jiménez M, Jurado M, De Cueto M, Miranda C, et al. Catheter infection by Mycoplasma hominis in a patient with acute lymphoblastic leukemia. Enfermedades infecciosas y microbiologia clinica. 1998;16(5):252-.
23. Krauze A, Krenke K, Matysiak M, Kulus M. Fatal course of pulmonary Absidia sp. infection in a 4-year-old girl undergoing treatment for acute lymphoblastic leukemia. Journal of pediatric hematology/oncology. 2005;27(7):386-8.
24. Su WD, Buechner S, Li C-Y. Clinicopathologic correlations in leukemia cutis. Journal of the American Academy of Dermatology. 1984;11(1):121-8.
25. Cho-Vega JH, Medeiros LJ, Prieto VG, Vega F. Leukemia cutis. American Journal of Clinical Pathology. 2008;129(1):130-42.
26. Sison EAR, Silverman LB. CNS prophylaxis in pediatric acute lymphoblastic leukemia. ASH Education Program Book. 2014;2014(1):198-201.
27. Rivera G, Mauer A, editors. Controversies in the management of childhood acute lymphoblastic leukemia: treatment intensification, CNS leukemia, and prognostic factors. Seminars in hematology; 1987: Elsevier.
28. Rives S EJ, Camós M, García-Miguel P, Verdeguer A, Couselo JM, Tasso M, Molina J,
Gómez P, Fernández-Delgado R, Navajas A, Badell I; grupo cooperativo SHOP (Sociedad Española de Hemato-Oncología Pediátrica). [T-cell pediatric acute lymphoblastic leukemia: analysis of survival and prognostic factors in 4 consecutive protocols of the Spanish cooperative study group SHOP]. Med Clin (Barc). 2012;139(4):141-9.
29. Saison J, Berger F, Lebosse F, Audoual R, Thomas X, Michallet M. Hepatomegaly and fever at the time of neutrophil recovery revealing L-asparaginase toxicity in the treatment of acute lymphoblastic leukemia. The American journal of case reports. 2014;15:13.
30. Ozsoylu S, Hiçsönmez G, Koçak N, Zamani V. Isolated splenomegaly during remission in childhood acute lymphoblastic leukemia. The Turkish journal of pediatrics. 1984;27(4):219-23.
31. Friedman A, Schauer P, Mertelsmann R, Cirrincione C, Thaler H, Dufour P, et al. The significance of splenomegaly in 101 adults with acute lymphoblastic leukemia (ALL) at presentation and during remission. Blood. 1981;57(4):798-801.
32. Simone JV, Verzosa MS, Rudy JA. Initial features and prognosis in 363 children with acute lymphocytic leukemia. Cancer. 1975;36(6):2099-108.
| Files | ||
| Issue | Vol 12 No 1 (2020) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/bccr.v12i1.5727 | |
| Keywords | ||
| Acute lymphoblastic leukemia ALL symptom leukemia | ||
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How to Cite
1.
Shahverdi E, Shahriari M, Zare S, Rahiminejad MS, Hosseinpour Soleimani F, Maki M, Manouchehri R, Haj Abdo M. Common Presenting Signs and Symptoms in Children with Acute Lymphoblastic Leukemia. Basic Clin Cancer Res. 2020;12(1):26-33.
