European Journal of Biomedical and Pharmaceutical Sciences

A STUDY ON PREVELANCE OF ACUTE LYMPHOID LEUKAEMIA IN KASHMIR REGION

*Bazila Bashir, Ks Rana, Dr. Pankaj Kaul, Hilal Mushtaq Lone, Sajid Ah Rather and Umer Nazir Ganie

ABSTRACT

This dissertation delved into the diagnostic process of Acute Lymphoid Leukemia (ALL), emphasizing the importance of integrating various hematological assessments, including Complete Blood Count (CBC), Peripheral Blood Film (PBF) examination, bone marrow analysis, and cytochemical staining. The study evaluated 100 patients diagnosed with ALL, with ages ranging from 2 to 60 years. The CBC findings provided crucial initial clues to the presence of ALL. The most common abnormalities included leukocytosis, with some cases showing extreme elevation in white blood cell counts, while others exhibited leukopenia. Anemia was nearly universal, reflected in significantly reduced hemoglobin levels. Thrombocytopenia was another consistent finding, with platelet counts frequently falling to critically low levels. These findings highlighted the extensive disruption of normal hematopoiesis in ALL, which often presents with such stark abnormalities. Peripheral Blood Film (PBF) examination was pivotal in identifying the morphological characteristics of lymphoblasts. These immature cells, a defining feature of ALL, were identified by their large size, high nuclear-cytoplasmic ratio, irregular nuclear contours, and prominent nucleoli. The PBF not only confirmed the presence of blasts but also allowed for an initial assessment of their characteristics, providing insight into the severity of the disease. Bone marrow examination was a cornerstone of this study, offering definitive diagnostic confirmation. The bone marrow aspirates from the patients consistently showed hypercellularity with a marked increase in lymphoblasts, often exceeding 20% of nucleated cells, a threshold that supports the diagnosis of ALL. The detailed analysis of bone marrow morphology provided further insights into the disease burden and allowed for the identification of high-risk patients, particularly those with extensive marrow involvement. Cytochemical staining added another layer of specificity to the diagnosis. Myeloperoxidase (MPO) staining was negative in most cases, effectively ruling out acute myeloid leukemia (AML). The blasts frequently exhibited positivity for periodic acid-Schiff (PAS) staining, which highlighted the presence of glycogen granules. Additionally, TdT (terminal deoxynucleotidyl transferase) staining was a key diagnostic marker, confirming the lymphoid origin of the blasts and helping to differentiate ALL from other hematological malignancies. The importance of this dissertation lies in its comprehensive approach to diagnosing ALL, underscoring the necessity of using multiple diagnostic tools in conjunction. By integrating CBC, PBF, bone marrow examination, and cytochemical staining, the study provided a robust framework for accurate diagnosis and classification of ALL, which is crucial for determining the appropriate treatment regimen. This research not only contributes to the existing knowledge base but also offers practical insights that can enhance diagnostic accuracy in clinical settings. The findings emphasize the critical role of a thorough, multi-faceted diagnostic strategy in managing a complex and aggressive disease like ALL, ultimately improving patient outcomes through timely and precise intervention.

Keywords: Acute lymphoid leukemia, Hematological Parameters, Bone Marrow.