Patient characteristics
Over a period of three years, we included 110 patients with ALL in the
study. The patient characteristics are shown in table 3. The median age
at diagnosis was 4.8 years, 23 patients (20.9 %) were older than 10
years and 2 patients (1.8 %) were infants under 1 year. The male to
female ratio was 1.39, with 64 male patients (58.2 %) and 46 female
patients (41.8 %). A higher male to female ratio was also reported for
a large cohort in Southeast Asia 8 and by the European
BFM Study group 9.
The median white blood cell (WBC) count at diagnosis was 40.65 x
109/l (interquartile range (IQR), 10 – 105.95 x
109/l). Fifty-three patients (48.2 %) initially had a
WBC count of more than 50 x 109/l, from the latter, 29
patients (26.4 %) suffered from hyperleukocytosis with a WBC count over
100 x 109/l, which is more than two fold more frequent
than in European patient populations 9 and in a large
South Asian cohort 8. This supports the clinical
impression that patients present late at the hospital with a high
disease burden. Consistently, the majority of patients, 63 (57.3 %) was
stratified into the HR group, mostly based on the high leukemia burden,
whereas 47 patients (42.7 %) were allocated to the SR group.
The major extramedullary disease manifestations were liver and spleen
enlargement in 80.9 % of patients and nodal involvement in 57.3%. 104
patients (94.5 %) were anemic at the time of diagnosis (hemoglobin (HGB
< 11 g/dl), the median HGB was 7.5 g/dl. CNS involvement was
detected in 3 patients (2.7%), which is within the expected range.