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    Case Study For Beta Acute Lymphoblastic Leukemia (B-All)

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    Shakira Hashim
    This case study describes a 7-year-old boy diagnosed with B-acute lymphoblastic leukemia (ALL) presenting with aplastic anemia. Laboratory findings showed pancytopenia, abnormal lymphocytes, and 82% lymphoblasts in bone marrow aspirate confirming ALL. Immunophenotyping and cytogenetics supported the diagnosis of precursor B-cell ALL. The patient's condition and laboratory results are described to demonstrate the clinical and pathological features used to diagnose this type of leukemia.

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    Case Study For Beta Acute Lymphoblastic Leukemia (B-All)

    Uploaded by

    Shakira Hashim
    96 views15 pages
    This case study describes a 7-year-old boy diagnosed with B-acute lymphoblastic leukemia (ALL) presenting with aplastic anemia. Laboratory findings showed pancytopenia, abnormal lymphocytes, and 82% lymphoblasts in bone marrow aspirate confirming ALL. Immunophenotyping and cytogenetics supported the diagnosis of precursor B-cell ALL. The patient's condition and laboratory results are described to demonstrate the clinical and pathological features used to diagnose this type of leukemia.

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    Case Study for Beta Acute Lymphoblastic Leukemia(B-All)

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    This case study describes a 7-year-old boy diagnosed with B-acute lymphoblastic leukemia (ALL) presenting with aplastic anemia. Laboratory findings showed pancytopenia, abnormal lymphocytes, and 82% lymphoblasts in bone marrow aspirate confirming ALL. Immunophenotyping and cytogenetics supported the diagnosis of precursor B-cell ALL. The patient's condition and laboratory results are described to demonstrate the clinical and pathological features used to diagnose this type of leukemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    96 views15 pages

    Case Study For Beta Acute Lymphoblastic Leukemia (B-All)

    Uploaded by

    Shakira Hashim
    This case study describes a 7-year-old boy diagnosed with B-acute lymphoblastic leukemia (ALL) presenting with aplastic anemia. Laboratory findings showed pancytopenia, abnormal lymphocytes, and 82% lymphoblasts in bone marrow aspirate confirming ALL. Immunophenotyping and cytogenetics supported the diagnosis of precursor B-cell ALL. The patient's condition and laboratory results are described to demonstrate the clinical and pathological features used to diagnose this type of leukemia.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    CASE STUDY FOR B-ACUTE

    LYMPHOBLASTIC LEUKEMIA (ALL)


    WITH PRESENCE OF APLASTIC ANEMIA

    BACHELOR IN MEDICAL LABORATORY SCIENCE

    PREPARED BY SHAKIRA BINTI HASHIM


    (4154009661)
    HOSPITAL TELUK INTAN
    OBJECTIVE

    To describe the clinical and laboratory features of


    Acute Lymphoblastic leukemia (ALL) patient
    Boy

    INTRODUCTION

    No known 7 years
    medical old
    illness
    HISTORY

    Fever

    Admitted for neutropenic sepsis

    Hepatosplenomegaly
    PHYSICAL EXAMINATION

    • axillary CHEST X-RAY


    • Multiple cervical
    lymph node • Patchy
    consolidational
    • Bilaterally inguinal
    perihilar region
    small lymph node
    • No mediastinal
    Palpable widening
    Lymph node
    LAB FINDINGS

    SEROLOGY

    Complement assay Result Flag Normal Range

    C3 Complement 2.05 G/L H 0.9-1.8

    C4 Complement 0.42 G/L H 0.1-0.4

    MICROBIOLOGY

    Blood Culture & Sensitivity Negative


    BIOCHEMISTRY

    Test Name Result Flag Reference Range


    Phosphate 0.85 mmol/L L 1.29-2.26
    RENAL PROFILE
    Sodium 132 mmol/L L 136-146
    Chloride 96 mmol/L L 101-109
    Creatinine 21 umol/L L 23-68
    LIVER FUNCTION TEST
    Globulin 37.8 g/L H 23-35
    Alkaline 314.02 u/L H 93-309
    Phosphatase
    CARDIAC ENZYME
    Lactate 1939.0 U/L H 110-295
    dehydrogenase
    HEMATOLOGY

    FULL BLOOD COUNT


    Parameter Diagnosis of Diagnosis of Recovery Reference
    AA ALL Range

    Time (weeks) 0 5 48
    Hemoglobin(g/dL) 8.1 6.7 11.4 11.5-13.5
    Lymphocyte 2.18 5.39 0.93 1.0–3.0
    (x103/uL)

    Peripheral blood 0 35 0 >30


    blasts (%)

    Neutrophils 0.73 0.89 3.36 2.0–7.0


    (103/uL)

    Platelet (103/uL) 145 104 302 150-400


    FULL BLOOD PICTURE

    Parameter Diagnosis of AA Diagnosis of ALL


    Time (weeks) 0 5
    Red Blood Cell • Normochromic normocytic • Dimorphic red cells
    anemia • NRBC seen
    • Anisocytosis
    • NRBC present
    White Blood Cell • Leukocytopenia with • Normal white cell count with
    neutropenia relative lymphocytosis and
    • No blast noted monocytosis
    • Abnormal lymphoid noted with
    some are blastoid looking and
    some having vacuolation
    Platelet • Adequate on fil >30/hpf Reduced platelet count <25/hpf

    Interpretation Pancytopenia Persistent pancytopenia with


    abnormal lymphoid cells
    BONE MARROW ASPIRATION

    Parameter Explanation

    Peripheral Blood Pancytopenia with some abnormal lymphoid (blastoid looking).

    Cellularity Hypercellular marrow both cell traits and fragments.

    Erythropoiesis Markedly suppressed.

    Granulopoiesis Markly supressed.

    Megakaryopoiesis Markly suppressed.

    Others 82% lymphoblasts counted. Moderate to large in size, high N:C ratio with inconspicious
    nucleoli. Some of the blasts exhibit vacuolation.
    Differential count Neutrophils :- Lymphocytes:-
    Metamyelocytes: 1% Monocytes:-
    Myelocytes: 4% Eosinophilic: 12%
    Blast: 82% Plasma cells : 1%

    Interpretation Morphologically, this aspirate findings are suggestive of Acute Lymphoblastic


    Leukemia(ALL) most probably L3(FAB classification)
    BMA (MICROSCOPIC)
    BONE MARROW BIOPSY

    Parameter Explanation

    Macroscopy Received multiple strips of brownish tissue measuring 3-15mm


    in aggregates. Entirely submitted in 1 block.
    Microscopy Generally inadequate, <5 marrow spaces. Cellular area ( 10-20%)
    Adequacy: are hypercellular.
    Interpretation Generally suboptimal sample, however with IHC findings,
    consistent with BMA findings of Acute Lymphoblastic Leukemia.
    MOLECULAR

    • Positive for CD34, CD79a, Tdt, CD20, and Cd10


    IHC • Negative for CD21 and MPO

    • Presence of 62% blast population expressing certain


    phenotypes that confirmed the findings with underlying
    IPT Precursor B-Acute Lymphoblastic Leukemia cALLA positive

    • 46,XY[8]
    Cytogenetics
    OUTCOME

    • The benefit of getting to know the flow in


    clinical and laboratory findings to diagnose this
    disease.
    • The advantages in studying the knowledge of
    interpreting each of the patient results.
    CONCLUSION

    • Childhood acute lymphoblastic leukemia have


    a high rate of incidence but also good
    prognosis.
    • However, it will be difficult for those with
    genetic abnormalities to be cured.
    • Thus, scientists or the medical healthcare
    need to create more advance technologies to
    discover more accurate treatment.

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