Abstract:
Background: Acute Lymphoblastic Leukemia (ALL) is the most common childhood malignancy,
characterized by the uncontrolled proliferation of lymphoid progenitor cells in bone marrow
(BM). Examining the BM is the method of choice for monitoring ALL, which can be challenging
and time-consuming. Although expensive Minimal Residual Disease (MRD) methods could be
used to monitor treatment, they are unfeasible for routine practice. Using PB parameters to screen
the bone marrow could provide a cost-effective alternative in the absence of MRD.
Objectives: To assess correlations between peripheral blood (PB) and BM parameters of B-Cell
Acute Lymphoblastic Leukemia (B-ALL) patients during post induction chemotherapy
Methods: A total of 75 newly diagnosed B-ALL patients who attended the Haematology clinic at
Apeksha Hospital, Maharagama, were selected for the study. Full Blood Count was performed by
Haematology analyzer (Mindray BC-6800), and the BM parameters of Blast% (BL%_BM) and
Lymphocyte% (L%_BM) were obtained from myelogram reports. The estimations were
performed for the 3 phases; Initial diagnosed (D0), Induction phase I- After 8 days chemotherapy
(D8) and Induction phase II- After 29 days chemotherapy (D29). Statistical analysis was
performed using SPSS version 26.0. The data was separately tested for normalization, followed by
Correlation bivariate analysis.
Results: The non-parametric Spearman’s correlations showed that the PB parameters have
stronger correlations with L%_BM than BL%_BM. The D8 correlations are prominent among all,
and it showed L%_PB and N%_PB have significant (p<0.01) positive and negative correlations
with L%_BM (r=0.365 & r=-0.341). BL%_BM too has a significant (p<0.01) negative correlation
(r=-0.337) with N%_PB in D0. In D29, only platelets showed a significant (p<0.05) weak
correlation (r=-0.246) with L%_BM.
Conclusion: There is a significant weak correlation between PB cell counts and BM cell counts
during the induction chemotherapy phase of B-ALL. Further studies are required to evaluate
applicability of these findings in B-ALL care.
