The relationship of bone marrow fibrosis at diagnosis with prognosis and survival in childhood acute lymphoblastic leukemia

Abstract

Objectives: Our aim in this study is to investigate the effect of fibrosis at diagnosis on treatment and survival in childhood acute lymphoblastic leukemia (ALL).

Methods: This study is retrospective. We evaluated the relationship between patients' age, white blood cell count at diagnosis, morphological blast percentage and flow cytometric blast percentage at diagnosis, day 15^th and day 33^th, absolute blast count in peripheral smear on day 8^th, and the degree of fibrosis in bone marrow biopsy at diagnosis in 36 pediatric patients. The fibrosis degree in biopsy on the thirty-third day after induction therapy was measured.

Results: Twenty-eight (77.8%) cases were diagnosed B-ALL and 8 T-ALL (22.2%). There was no statistically significant difference between the groups with and without fibrosis in terms of any parameter measured at the time of diagnosis, 8^th day, 15^th day, and 33^th day. No significant difference was found between the groups according to overall survival (OS): the mean OS was 50.22 ± 5.44 months in the fibrosis group and 49.70 ± 3.96 months in the non-fibrosis group (p = 0.557).

Conclusions: There is a high detection rate of bone marrow fibrosis in ALL pediatric cases at the time of diagnosis. Nevertheless, fibrosis does not affect survival.

Keywords

• Leukemia
• fibrosis
• bone marrow
• childhood
• lymphoblastic
• microenvironment

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