Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis
Background Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Emergency complications such as hyperleukocytosis can arise as the disease develops. Exchange transfusion is one of many cytoreductive modalities to resolve the condition. Objective To analyze the clinical and labo...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Indonesian Pediatric Society Publishing House
2023-11-01
|
| Series: | Paediatrica Indonesiana |
| Subjects: | |
| Online Access: | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3223 |
| _version_ | 1797370076211445760 |
|---|---|
| author | Rasya Azka Lazuwardi Mia Ratwita Andarsini Yetti Hernaningsih |
| author_facet | Rasya Azka Lazuwardi Mia Ratwita Andarsini Yetti Hernaningsih |
| author_sort | Rasya Azka Lazuwardi |
| collection | DOAJ |
| description | Background Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Emergency complications such as hyperleukocytosis can arise as the disease develops. Exchange transfusion is one of many cytoreductive modalities to resolve the condition.
Objective To analyze the clinical and laboratory effects of exchange transfusion in childhood acute lymphoblastic leukemia patients with hyperleukocytosis.
Methods This analytical retrospective cohort study with a pre- and post-test design used secondary medical record data. The obtained characteristics were the incidences of dyspnea, tachypnea, headache, intracranial bleeding, hepatomegaly, splenomegaly, lymphadenopathy, abdominal pain, fever, pallor, nausea/vomiting, and skin or mucosal bleeding; hemoglobin, white blood cell, and platelet counts; and serum potassium, sodium, calcium, phosphate, blood urea nitrogen, and creatinine levels.
Results A total of 16 patients underwent exchange transfusion; they had significant reductions of the incidence of dyspnea, tachypnea, hepatomegaly, and pallor and significant improvement in the form of elevation of hemoglobin level and decrease in white blood cell counts (P<0.05 for all) compared to pre-treatment. The remainder of the variables were not significantly different between pre- and post-treatment, but a general decrease in all clinical manifestations except intracranial bleeding was observed.
Conclusion Exchange transfusion has the beneficial effect of resolving hyperleukocytosis and its manifestations, although correction in laboratory outcomes that remained abnormal are still needed. |
| first_indexed | 2024-03-08T17:56:08Z |
| format | Article |
| id | doaj.art-5cd0df3566854b5aa1e4136b3f8d0924 |
| institution | Directory Open Access Journal |
| issn | 0030-9311 2338-476X |
| language | English |
| last_indexed | 2024-03-08T17:56:08Z |
| publishDate | 2023-11-01 |
| publisher | Indonesian Pediatric Society Publishing House |
| record_format | Article |
| series | Paediatrica Indonesiana |
| spelling | doaj.art-5cd0df3566854b5aa1e4136b3f8d09242024-01-02T04:40:25ZengIndonesian Pediatric Society Publishing HousePaediatrica Indonesiana0030-93112338-476X2023-11-016364647110.14238/pi63.6.2023.464-713223Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosisRasya Azka Lazuwardi0Mia Ratwita Andarsini1Yetti Hernaningsih2Faculty of Medicine Universitas Airlangga, Surabaya, East JavaDepartment of Pediatric, Faculty of Medicine Universitas Airlangga, Surabaya, East JavaDepartment of Clinical Pathology, Faculty of Medicine Universitas Airlangga, Surabaya, East JavaBackground Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Emergency complications such as hyperleukocytosis can arise as the disease develops. Exchange transfusion is one of many cytoreductive modalities to resolve the condition. Objective To analyze the clinical and laboratory effects of exchange transfusion in childhood acute lymphoblastic leukemia patients with hyperleukocytosis. Methods This analytical retrospective cohort study with a pre- and post-test design used secondary medical record data. The obtained characteristics were the incidences of dyspnea, tachypnea, headache, intracranial bleeding, hepatomegaly, splenomegaly, lymphadenopathy, abdominal pain, fever, pallor, nausea/vomiting, and skin or mucosal bleeding; hemoglobin, white blood cell, and platelet counts; and serum potassium, sodium, calcium, phosphate, blood urea nitrogen, and creatinine levels. Results A total of 16 patients underwent exchange transfusion; they had significant reductions of the incidence of dyspnea, tachypnea, hepatomegaly, and pallor and significant improvement in the form of elevation of hemoglobin level and decrease in white blood cell counts (P<0.05 for all) compared to pre-treatment. The remainder of the variables were not significantly different between pre- and post-treatment, but a general decrease in all clinical manifestations except intracranial bleeding was observed. Conclusion Exchange transfusion has the beneficial effect of resolving hyperleukocytosis and its manifestations, although correction in laboratory outcomes that remained abnormal are still needed.https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3223acute lymphoblastic leukemiachildhood allpediatricexchange transfusion |
| spellingShingle | Rasya Azka Lazuwardi Mia Ratwita Andarsini Yetti Hernaningsih Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis Paediatrica Indonesiana acute lymphoblastic leukemia childhood all pediatric exchange transfusion |
| title | Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis |
| title_full | Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis |
| title_fullStr | Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis |
| title_full_unstemmed | Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis |
| title_short | Clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis |
| title_sort | clinical and laboratory effects of exchange transfusion in pediatric acute lymphoblastic leukemia with hyperleukocytosis |
| topic | acute lymphoblastic leukemia childhood all pediatric exchange transfusion |
| url | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3223 |
| work_keys_str_mv | AT rasyaazkalazuwardi clinicalandlaboratoryeffectsofexchangetransfusioninpediatricacutelymphoblasticleukemiawithhyperleukocytosis AT miaratwitaandarsini clinicalandlaboratoryeffectsofexchangetransfusioninpediatricacutelymphoblasticleukemiawithhyperleukocytosis AT yettihernaningsih clinicalandlaboratoryeffectsofexchangetransfusioninpediatricacutelymphoblasticleukemiawithhyperleukocytosis |