Acute leukaemia in children: Diagnosis and first line management in General Paediatrics

Abstract

Introduction: Acute leukemias represent about 30% of malignant hematologic diseases in children. Their variable clinical presentation can delay diagnosis and initial management. The objective was to describe the circumstances of presentation, diagnostic procedures, and initial therapeutic measures taken before transfer to a specialized unit. Patients and methods: Retrospective descriptive study in the Paediatric Medicine Department B, from January 2018 to December 2023. Results: Twenty-four cases were collected, sex ratio 1.4, mean age 6 years. Average time from symptom onset to hospitalization was 27 days. Main symptoms were prolonged fever (13 cases), deterioration of general health (12 cases), bone pain/arthralgia (6 cases), and tumoral (8 cases) or haemorrhagic syndromes (5 cases). Bone marrow aspiration confirmed diagnosis in 21 cases: 15 acute lymphoblastic leukemias, 5 acute myeloblastic leukemias, and 1 undifferentiated. Mean transfer delay to specialized unit was 4.6 days. Conclusion: Peripheral blood smear should be performed at the slightest acute leukemia suspicion to guide diagnosis and start appropriate management before transfer.