Clinico-Hematological Profile of Children and Adolescents With Chronic Myeloid Leukemia: A Study at a Tertiary Care Institute in India

TL;DR

This study examines the blood and clinical features of children and teens with chronic myeloid leukemia in India and their response to treatment.

Contribution

The study provides insights into the clinico-hematological profile of CML in Indian children and adolescents.

Findings

Most patients presented with splenomegaly and anemia.

White blood cell counts were higher in children compared to adults.

Long-term outcomes of TKI treatment in this population remain unclear.

Abstract

Background

Chronic myeloid leukemia (CML) rarely occurs in the first few decades of life, accounting for 2% to 3% of leukemias in children and adolescents. Children and adolescents with CML tend to present with more aggressive features. Because of the substantial shift in CML treatment brought about by the development of tyrosine kinase inhibitors (TKIs) in the last 20 years, adult patients now have about the same life expectancy as the age-matched healthy population. The study evaluated the clinico-hematological profile of children presenting with CML. Also, the response to the treatment provided was analyzed.

Materials and methods

It is a retrospective-observational study conducted in the Department of Hematology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. The Institutional Ethics Committee (IEC), IGIMS, Patna, Bihar, India, granted ethical approval under letter 1370/IEC/IGIMS/2024, dated 20 March 2024.

Results

Out of 180 cases detected from records of the previous six years, i.e., from 2018 to 2023, only 20 records of CML were found in children and adolescents. Among them, 17 (85%) patients had splenomegaly, 16 (80%) had anemia, 10 (50%) had hepatomegaly, and two (10%) had fever.

Conclusion

The study concluded that the presenting features of CML in children and adolescents were similar to those shown in other studies. WBC counts were higher in children and adolescents compared to the adult population. Also, the long-term outcomes of TKI treatment and the late effects of life-long TKI treatment need to be defined.