Clinico-hematological characteristics of hematological malignancy in pediatric age group in Madhya Pradesh: A tertiary care experience

Background: Hematological malignancies, encompassing leukemia, lymphoma, and myeloma, constitute a significant cause of morbidity and mortality. Early diagnosis plays a pivotal role in improving prognosis and facilitating risk-adapted therapeutic strategies. Aims and Objectives: The study was conducted to determine the prevalence and the clinico-hematological profile of hematological malignancies. Materials and Methods: A hospital-based prospective observational study was conducted over 1 year. Clinical and demographic data were collected, and investigations, including complete blood count, peripheral smear, bone marrow examination, immunophenotyping, and flow cytometry, were performed. Results: Acute lymphoblastic leukemia (ALL) is the most common hematological malignancy among pediatric patients in the present study, with 59 out of 78 patients (75.6%). Other malignancies are acute myeloid leukemia (AML) (14.1%), chronic myeloid leukemia (5.1%), and lymphoma (3.9%). Definite male preponderance (59%) was observed, and mostly the disease symptoms presented early in life. We found 47.4% of patients were below 5 years of age. Common clinical features included fever (97.4%), pallor (94.9%), and central nervous system involvement, which was seen in 30.8%. Bone marrow failure was seen in most of the patients during 1st presentation, i.e., hemoglobin was <7 g/dL in 53.8%, between 7 and 11 g/dL in 42.3% patients; platelet count was <20,000 cells/mm3 in 26.9%, whereas hyperleukocytosis was seen with white blood cell count >50,000 cells/mm3 in 43.6% patients. Conclusion: B-cell acute lymphoblastic leukemia is the most common pediatric hematological malignancy, followed by AML and T-cell ALL. These malignancies predominantly affect children under 5 years of age, with a male predominance. Fever and pallor were the most common clinical features.