Abstract
Background: Pediatric acute leukemia is the most prevalent childhood malignancy worldwide. Establishing baseline clinical and hematological profiles at initial presentation is vital for enhancing diagnostic vigilance and optimizing patient outcomes, particularly in resource-limited settings. This study aimed to evaluate the initial clinical manifestations, laboratory features, and morphological subtypes of childhood acute leukemia at a tertiary care hospital in Dhaka, Bangladesh.
Methods: This retrospective observational study evaluated 42 pediatric patients (aged 6 months to 15 years) with newly diagnosed acute leukemia admitted to a tertiary care hospital in Dhaka, Bangladesh. Secondary and relapsed cases were excluded. Diagnosis and morphological subtyping were established via peripheral blood evaluation and bone marrow cytological examination utilizing the French–American–British (FAB) classification system. Data were analyzed using SPSS version 26, and descriptive statistics were used.
Results: Acute lymphoblastic leukemia (ALL) was the predominant malignancy, accounting for 73.8% (n = 31) of cases, followed by acute myeloid leukemia (AML) in 19% (n = 8) and biphenotypic leukemia in 7.1% (n = 3). Morphological subtyping of ALL revealed L1 as the dominant variant (54.8%), followed by L2 (35.5%) and L3 (9.7%). Among AML cases, M2 and M3 were the most frequent subtypes (37.5% each). The primary presenting symptoms were fever (73.8%), fatigue (66.7%), pallor (64.3%), mucocutaneous bleeding (59.5%), and anorexia (52.4%). Major physical examination findings included hepatomegaly (57.1%), splenomegaly (50%), and generalized lymphadenopathy (45.2%). Hyperleukocytosis (>1,00,000/mm³) was present in 9 patients (21.4%), and severe thrombocytopenia (<10,000/mm³) was observed in 6 patients (14.3%).
Conclusion: Acute lymphoblastic leukemia (FAB L1) is the primary pediatric hematological malignancy in this Bangladeshi cohort. Fever, constitutional symptoms, features of bone marrow failure (pallor, bleeding), and organomegaly represent the cardinal initial manifestations. Increased clinical awareness among primary healthcare providers is essential for timely referral, early diagnostic confirmation, and prompt initiation of therapy.
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Copyright (c) 2026 Umme Nusrat Ara, Moklesur Rahman, Tania Sultana, Tapas Chowdhury, Zamil Ahmed Manik