Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia

Abdulkader Memeh; Abduljalil Ghriwati; Ibrahim Kebbe War; Khalid Khanji

Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia

Abstract

Acute lymphoblastic leukemia is a specific type of hematologic neoplasm in which outcomes may be affected by many variables such as the patient's age, gender, conventional karyotyping reports, lactate dehydrogenase concentration, and white blood cell count at diagnosis. The aim of this study was to assess the prognostic significance of those factors on the overall survival of patients diagnosed with ALL. The current study includes 65 patients diagnosed with ALL who were tested for cytology, conventional karyotyping, and immunophenotyping. The results of the current study have indicated the average patient’s age was 14 years old. In addition, around 47.7% of patients had chromosomal abnormalities. Furthermore, the patients with LDH levels higher than 450 IU/L, and WBC counts over 100 X109 (Cell /L) had a shorter overall survival in month compared to other groups. However, the results suggested that conventional karyotyping, LDH, and WBC count might be used as good prognostic tests in patients with ALL at diagnosis.

Keywords

References

[1] Möricke A, Zimmermann M, Reiter A, Gadner H, Odenwald E, Harbott J, Ludwig WD, Riehm H, Schrappe M. Prognostic impact of age in children and adolescents with acute lymphoblastic leukemia: data from the trials ALL-BFM 86, 90, and 95. Klin Padiatr. 2005;217(6):310-320. https://doi.org/10.1055/s-2005-872515.
[2] Lustosa de Sousa DW, de Almeida Ferreira FV, Cavalcante Félix FH, de Oliveira Lopes MV. Acute lymphoblastic leukemia in children and adolescents: Prognostic factors and analysis of survival. Rev Bras Hematol Hemoter. 2015;37(4):223-229. https://doi.org/10.1016/j.bjhh.2015.03.009.
[3] Iacobucci I, Papayannidis C, Lonetti A, Ferrari A, Baccarani M, Martinelli G. Cytogenetic and molecular predictors of outcome in acute lymphocytic leukemia: recent developments. Curr Hematol Malig Rep. 2012;7(2):133-143. https://doi.org/10.1007/s11899-012-0122-5.
[4] Udayakumar AM, Bashir WA, Pathare AV, Wali YA, Zacharia M, Khan AA, Soliman H, Al-Lamki Z, Raeburn JA. Cytogenetic profile of childhood acute lymphoblastic leukemia in Oman. Arch Med Res. 2007;38(3):305-312. https://doi.org/10.1016/j.arcmed.2006.10.006.
[5] Harrison CJ, Johansson, B. Acute lymphoblastic leukemia. In: Cancer Cytogenetics: Chromosomal and Molecular Genetic Aberrations of Tumor Cells, Fourth Edition. Wiley Blackwell, 2015. https://doi.org/10.1002/9781118795569.
[6] Shago M. Recurrent cytogenetic abnormalities in acute lymphoblastic leukemia. Methods Mol Biol. 2017;1541:257-278. https://doi.org/10.1007/978-1-4939-6703-2_21.
[7] Hafiz MG, Mannan MA. Serum lactate dehydrogenase level in childhood acute lymphoblastic leukemia. Bangladesh Med Res Counc Bull. 2007;33(3):88-91. https://doi.org/10.3329/bmrcb.v33i3.1139.
[8] Liberti MV, Locasale JW. Correction to: 'The Warburg Effect: How Does it Benefit Cancer Cells?': [Trends in Biochemical Sciences, 41 (2016) 211]. Trends Biochem Sci. 2016;41(3):287. https://doi.org/10.1016/j.tibs.2016.01.004.

[9] Geva M, Pryce A, Shouval R, Fein JA, Danylesko I, Shem-Tov N, Yerushalmi R, Shimoni A, Szydlo R, Pavlu J, Nagler A. High lactate dehydrogenase at time of admission for allogeneic hematopoietic transplantation associates to poor survival in acute myeloid leukemia and non-Hodgkin lymphoma. Bone Marrow Transplant. 2021;56(11):2690-2696. https://doi.org/10:1038/s41409-021-01377-9.
[10] Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, Richardson P, Caltagirone S, Lahuerta JJ, Facon T, Bringhen S, Gay F, Attal M, Passera R, Spencer A, Offidani M, Kumar S, Musto P, Lonial S, Petrucci MT, Orlowski RZ, Zamagni E, Morgan G, Dimopoulos MA, Durie BG, Anderson KC, Sonneveld P, San Miguel J, Cavo M, Rajkumar SV, Moreau P. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. Revised ınternational staging system for multiple myeloma: A report from ınternational myeloma working group. J Clin Oncol. 2015;33(26):2863-2869. https://doi.org/10.1200/JCO.2015.61.2267.
[11] Kim SJ, Hong JS, Chang MH, Kim JA, Kwak JY, Kim JS, Yoon DH, Lee WS, Do YR, Kang HJ, Eom HS, Park Y, Won JH, Mun YC, Kim HJ, Kwon JH, Kong JH, Oh SY, Lee S, Bae SH, Yang DH, Jun HJ, Kim YS, Yun HJ, Lee SI, Kim MK, Park EK, Kim WS, Suh C. Highly elevated serum lactate dehydrogenase is associated with central nervous system relapse in patients with diffuse large B-cell lymphoma: Results of a multicenter prospective cohort study. Oncotarget. 2016;7(44):72033-72043. https://doi.org/10.18632/oncotarget.12459.
[12] Germing U, Hildebrandt B, Pfeilstöcker M, Nösslinger T, Valent P, Fonatsch C, Lübbert M, Haase D, Steidl C, Krieger O, Stauder R, Giagounidis AA, Strupp C, Kündgen A, Mueller T, Haas R, Gattermann N, Aul C. Refinement of the international prognostic scoring system (IPSS) by including LDH as an additional prognostic variable to improve risk assessment in patients with primary myelodysplastic syndromes (MDS). Leukemia. 2005;19(12):2223-2231. https://doi.org/10.1038/sj.leu.2403963.
[13] García R, Hernández JM, Caballero MD, González M, Galende J, del Cañizo MC, Vázquez L, San Miguel JF. Serum lactate dehydrogenase level as a prognostic factor in Hodgkin's disease. Br J Cancer. 1993;68(6):1227-1231. https://doi.org/10.1038/bjc.1993.509.
[14] Xiao Z, Gong R, Chen X, Xiao D, Luo S, Ji Y. Association between serum lactate dehydrogenase and 60-day mortality in Chinese Hakka patients with acute myeloid leukemia: A cohort study. J Clin Lab Anal. 2021;35(12):e24049. https://doi.org/10.1002/jcla.24049.
[15] Röllig C, Thiede C, Gramatzki M, Aulitzky W, Bodenstein H, Bornhäuser M, Platzbecker U, Stuhlmann R, Schuler U, Soucek S, Kramer M, Mohr B, Oelschlaegel U, Stölzel F, von Bonin M, Wermke M, Wandt H, Ehninger G, Schaich M; Study Alliance Leukemia. A novel prognostic model in elderly patients with acute myeloid leukemia: results of 909 patients entered into the prospective AML96 trial. Blood. 2010;116(6):971-978. https://doi.org/10.1182/blood-2010-01-267302.
[16] Ganzel C, Becker J, Mintz PD, Lazarus HM, Rowe JM. Hyperleukocytosis, leukostasis and leukapheresis: practice management. Blood Rev. 2012;26(3):117-122. https://doi.org/10.1016/j.blre.2012.01.003.
[17] Kong SG, Seo JH, Jun SE, Lee BK, Lim YT. Childhood acute lymphoblastic leukemia with hyperleukocytosis at presentation. Blood Res. 2014;49(1):29-35. https://doi.org/10.5045/br.2014.49.1.29.
[18] Chainansamit S. The effect of hyperleukocytosis on the survival rate for childhood acute lymphoblastic leukemia. J Med Assoc Thailand. 2022; 105(7): 616-622.‏ https://doi.org/10.35755/jmedassocthai.2022.07.13337.
[19] Graux C. Biology of acute lymphoblastic leukemia (ALL): Clinical and therapeutic relevance. Transfus Apher Sci. 2011;44(2):183-189. https://doi.org/10.1016/j.transci.2011.01.009.
[20] Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics. CA Cancer J Clin. 2014;64(2):83-103. https://doi.org/10.3322/caac.21219.
[21] Kulkarni KP, Arora RS, Marwaha RK. Survival outcome of childhood acute lymphoblastic leukemia in India: a resource-limited perspective of more than 40 years. J Pediatr Hematol Oncol. 2011;33(6):475-479. https://doi.org/10.1097/MPH.0b013e31820e7361.
[22] Hosseini S, Ansari S, Vosough P, Bahoush G, Hamidieh AA, Chahardouli B, Shamsizadeh M, Mehrazma M, Dorgalaleh A. Bilateral maxillary, sphenoid sinuses and lumbosacral spinal cord extramedullary relapse of CML following allogeneic stem cell transplant. Int J Hematol Oncol Stem Cell Res. 2016;10(2):106-110.
[23] Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/archive/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014. [24] Luca DC. Update on lymphoblastic leukemia/lymphoma. Clin Lab Med. 2021;41(3):405-416. https://doi.org/10.1016/j.cll.2021.04.003.
[25] Unal S, Ozbek N, Kara A, Alikaşifoĝlu M, Gümrük F. Five Fanconi anemia patients with unusual organ pathologies. Am J Hematol. 2004;77(1):50-54. https://doi.org/10.1002/ajh.20130.
[26] Sasaki K, Jabbour E, Short NJ, Jain N, Ravandi F, Pui CH, Kantarjian H. Acute lymphoblastic leukemia: A population-based study of outcome in the United States based on the surveillance, epidemiology, and end results (SEER) database, 1980-2017. Am J Hematol. 2021;96(6):650-658. https://doi.org/10.1002/ajh.26156. Erratum in: Am J Hematol. 2021. https://doi.org/10.1002/ajh.26156.
[27] Bănescu C, Benedek I, Carmen D, Smaranda D, Macarie I, Voidazan S, Dobreanu M. The Prognostic Impact of the Karyotype in Patients with Acute Lymphoblastic Leukemia. Acta Medica Marisiensis. 2012;58(6): 359-362.
[28] Abbasi S, Maleha F, Shobaki M. Acute lymphoblastic leukemia experience: epidemiology and outcome of two different regimens. Mediterr J Hematol Infect Dis. 2013;5(1):e2013024. https://doi.org/10.4084/MJHID.2013.024.
[29] Chennamaneni R, Gundeti S, Konatam ML, Bala S, Kumar A, Srinivas L. Impact of cytogenetics on outcomes in pediatric acute lymphoblastic leukemia. South Asian J Cancer. 2018;7(4):263-266. https://doi.org/10.4103/sajc.sajc_13_18.
[30] Li SY, Ye JY, Meng FY, Li CF, Yang MO. Clinical characteristics of acute lymphoblastic leukemia in male and female patients: A retrospective analysis of 705 patients. Oncol Lett. 2015;10(1):453-458. https://doi.org/10.3892/ol.2015.3202.
[31] Matsumura T, Kami M, Yamaguchi T, Yuji K, Kusumi E, Taniguchi S, Takahashi S, Okada M, Sakamaki H, Azuma H, Takanashi M, Kodo H, Kai S, Inoue-Nagamura T, Kato K, Kato S; Japan Cord Blood Bank Network. Allogeneic cord blood transplantation for adult acute lymphoblastic leukemia: retrospective survey involving 256 patients in Japan. Leukemia. 2012;26(7):1482-1486. https://doi.org/10.1038/leu.2012.11.
[32] Orzołek I, Sobieraj J, Domagała-Kulawik J. Estrogens, cancer and immunity. Cancers (Basel). 2022;14(9):2265.. https://doi.org/10.3390/cancers14092265.
[33] Kim HI, Lim H, Moon A. Sex differences in cancer: epidemiology, genetics and therapy. Biomol Ther (Seoul). 2018;26(4):335-342. https://doi.org/10.4062/biomolther.2018.103.
[34] Vidya J, Ajeesh GA, Akhil KS. Challenges of pre-analytical variables in conventional cytogenetics—a university teaching hospital experience. Int J Curr Res Rev. 2020;12: 51-55. ‏ [35] Santos MFM, Oliveira FCAC, Kishimoto RK, Borri D, Santos FPS, Campregher PV, Silveira PAA, Hamerschlak N, Mangueira CLP, Duarte FB, Crepaldi AH, Salvino MA, Velloso EDRP. Pre-analytical parameters associated with unsuccessful karyotyping in myeloid neoplasm: a study of 421 samples. Braz J Med Biol Res. 2019 Feb 14;52(2):e8194. https://doi.org/10.1590%2F1414-431X20188194.
[36] Pui CH, Sandlund JT, Pei D, Campana D, Rivera GK, Ribeiro RC, Rubnitz JE, Razzouk BI, Howard SC, Hudson MM, Cheng C, Kun LE, Raimondi SC, Behm FG, Downing JR, Relling MV, Evans WE; Total Therapy Study XIIIB at St Jude Children's Research Hospital. Improved outcome for children with acute lymphoblastic leukemia: results of Total Therapy Study XIIIB at St Jude Children's Research Hospital. Blood. 2004 ;104(9):2690-2696. https://doi.org/10.1182/blood-2004-04-1616.
[37] Bassan R. Evolving strategies for the management of high-risk adult acute lymphoblastic leukemia. Haematologica. 2005;90(10):1299.
[38] Amare P, Gladstone B, Varghese C, Pai S, Advani S. Clinical significance of cytogenetic findings at diagnosis and in remission in childhood and adult acute lymphoblastic leukemia: experience from India. Cancer Genet Cytogenet. 1999;110(1):44-53. https://doi.org/10.1016/s0165-4608(98)00179-4.
[39] Larson RA. Management of acute lymphoblastic leukemia in older patients. Semin Hematol. 2006;43(2):126-133. https://doi.org/10.1053/j.seminhematol.2006.01.007.
[40] Farhana A, Lappin SL. Biochemistry, Lactate Dehydrogenase. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 8, 2022.
[41] Holmes RS, Goldberg E. Computational analyses of mammalian lactate dehydrogenases: human, mouse, opossum and platypus LDHs. Comput Biol Chem. 2009;33(5):379-385. https://doi:10.1016/j.compbiolchem.2009.07.006.
[42] Walaa Fikry ME. Lactate dehydrogenase (LDH) as prognostic marker in acute leukemia quantitative method. J Blood Disord Transfus. 2017;8:1.
[43] Hafiz MG, Rahman MM, Mannan MA. Serum lactate dehydrogenase as a prognostic marker of childhood acute lymphoblastic leukemia. Mymensingh Med J. 2008;17(2):169-173.
[44] Liu R, Cao J, Gao X, Zhang J, Wang L, Wang B, Guo L, Hu X, Wang Z. Overall survival of cancer patients with serum lactate dehydrogenase greater than 1000 IU/L. Tumour Biol. 2016;37(10):14083-14088. https://doi.org/10.1007/s13277-016-5228-2.
[45] Alfina D, Widjajanto PH, Patria SY. The outcomes of childhood acute lymphoblastic leukemia with hyperleukocytosis. Paediatrica Indonesiana 2018; 58(4):186-191.https://doi.org/10.14238/pi58.4.2018.186-91.
[46] Giammarco S, Chiusolo P, Piccirillo N, Di Giovanni A, Metafuni E, Laurenti L, Sica S, Pagano L. Hyperleukocytosis and leukostasis: management of a medical emergency. Expert Rev Hematol. 2017;10(2):147-154. https://doi:10.1080/17474086.2017.1270754.
[47] Macaron W, Sargsyan Z, Short NJ. Hyperleukocytosis and leukostasis in acute and chronic leukemias. Leuk Lymphoma. 2022;63(8):1780-1791. https://doi.org/10.1080/10428194.2022.2056178.

Details

Primary Language

English

Subjects

Pharmacology and Pharmaceutical Sciences (Other)

Journal Section

Research Article

Authors

Abdulkader Memeh ^* This is me
0000-0003-3955-2913
Syria

Abduljalil Ghriwati This is me
Syria

Ibrahim Kebbe War This is me
0000-0002-3495-5476
Syria

Khalid Khanji This is me
Syria

Publication Date

June 28, 2025

Submission Date

February 13, 2023

Acceptance Date

May 16, 2023

Published in Issue

Year 2023 Volume: 27 Number: 6

IZ

https://izlik.org/JA58XW65YA

Cite

RIS / Bibtex

APA

Memeh, A., Ghriwati, A., War, I. K., & Khanji, K. (2025). Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia. Journal of Research in Pharmacy, 27(6), 2342-2352. https://izlik.org/JA58XW65YA

AMA

1.Memeh A, Ghriwati A, War IK, Khanji K. Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia. J. Res. Pharm. 2025;27(6):2342-2352. https://izlik.org/JA58XW65YA

Chicago

Memeh, Abdulkader, Abduljalil Ghriwati, Ibrahim Kebbe War, and Khalid Khanji. 2025. “Evaluation of Conventional Karyotyping, Lactate Dehydrogenase Levels, White Blood Cell Count, and Bone Marrow Blast Percentage As Good Prognostic Tests in Patients With Acute Lymphoblastic Leukemia”. Journal of Research in Pharmacy 27 (6): 2342-52. https://izlik.org/JA58XW65YA.

EndNote

Memeh A, Ghriwati A, War IK, Khanji K (July 1, 2025) Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia. Journal of Research in Pharmacy 27 6 2342–2352.

IEEE

[1]A. Memeh, A. Ghriwati, I. K. War, and K. Khanji, “Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia”, J. Res. Pharm., vol. 27, no. 6, pp. 2342–2352, July 2025, [Online]. Available: https://izlik.org/JA58XW65YA

ISNAD

Memeh, Abdulkader - Ghriwati, Abduljalil - War, Ibrahim Kebbe - Khanji, Khalid. “Evaluation of Conventional Karyotyping, Lactate Dehydrogenase Levels, White Blood Cell Count, and Bone Marrow Blast Percentage As Good Prognostic Tests in Patients With Acute Lymphoblastic Leukemia”. Journal of Research in Pharmacy 27/6 (July 1, 2025): 2342-2352. https://izlik.org/JA58XW65YA.

JAMA

1.Memeh A, Ghriwati A, War IK, Khanji K. Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia. J. Res. Pharm. 2025;27:2342–2352.

MLA

Memeh, Abdulkader, et al. “Evaluation of Conventional Karyotyping, Lactate Dehydrogenase Levels, White Blood Cell Count, and Bone Marrow Blast Percentage As Good Prognostic Tests in Patients With Acute Lymphoblastic Leukemia”. Journal of Research in Pharmacy, vol. 27, no. 6, July 2025, pp. 2342-5, https://izlik.org/JA58XW65YA.

Vancouver

1.Abdulkader Memeh, Abduljalil Ghriwati, Ibrahim Kebbe War, Khalid Khanji. Evaluation of conventional karyotyping, lactate dehydrogenase levels, white blood cell count, and bone marrow blast percentage as good prognostic tests in patients with acute lymphoblastic leukemia. J. Res. Pharm. [Internet]. 2025 Jul. 1;27(6):2342-5. Available from: https://izlik.org/JA58XW65YA