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      Hematological malignancies in relation with ABO blood group at a teaching hospital, Varanasi, India

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          Abstract

          Background:

          There has been enormous progress in the diagnosis and treatment modalities of leukemia, but its pattern and prevalence vary throughout India. This inter-regional variation may be due to geographic, cultural or racial variation or maybe due deficiency in case of notification, especially in rural areas.

          Objective:

          The aim of our study is to determine the prevalence of different types of hematological malignancies with the ABO blood group at a teaching hospital in Varanasi, India. This cross-sectional study of 77 cases was conducted during 2016–2017 at a tertiary care center. We analyzed the age, sex, subtype of leukemia, blood group, clinical features, and laboratory parameters of patients. Age ranged between 1 year and 81 years with a male to female ratio of 1.9:1. A total of 66.3% of patients were suffering from acute leukemia and 33.7% from chronic leukemia. The most common blood group was B positive (44.8%) but no significant association was found ( P = 0.822). Fever (76.6%) and generalized weakness/easy fatigability (46.75%) were common complaints, whereas pallor (68.8%) and splenomegaly (51.9%) were common signs. Cases were from 23 districts of eastern Uttar Pradesh and western Bihar. The majority of the cases (70.12%) were from 8 districts (Jaunpur, Varanasi, Azamgarh, Ballia, Bhadhoi, Gazipur, Kaimur, Rohtas) of Uttar Pradesh, India and Aurangabad district of Bihar. Acute leukemia is more prevalent than chronic leukemia with more male preponderance. Acute lymphoblastic leukemia (ALL) were commonly found in children, acute myeloid leukemia (AML) was found in both children and adults. Chronic Myeloid Leukemia (CML) and chronic lymphocytic leukemia (CLL) mainly noted in adults. Unclassified acute leukemia was seen mainly in children and young adults. Anemia was more severe in acute conditions and thrombocytopenia was also more in acute leukemia. The most common blood group was B positive.

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          Treatment of adult acute lymphoblastic leukemia (ALL): long-term follow-up of the GIMEMA ALL 0288 randomized study.

          A Tabilio, Andrea Camera, Sergio Amadori … (2002)
          The GIMEMA ALL 0288 trial was designed to evaluate the impact of a 7-day prednisone (PDN) pretreatment on complete remission (CR) achievement and length, the influence of the addition of cyclophosphamide (random I) to a conventional 4-drug induction on CR rate and duration, and whether an early post-CR intensification (random II) by an 8-drug consolidation could improve CR duration. Median follow-up of this study was 7.3 years. From January 1988 to April 1994, among 794 adult (> 12 but < 60 years) patients registered, 778 were eligible. Their median age was 27.5 years; 73% had B-lineage acute lymphoblastic leukemia (ALL) and 22% had T-lineage disease; 18% showed associated myeloid markers; 47 of 216 analyzed patients (22%) had Philadelphia chromosome-positive ALL. Response to PDN pretreatment was observed in 65% of cases. CR was achieved in 627 patients (82%). Resistant patients and induction death rates were 11% and 7%, respectively. Random II was applied to 388 patients with CR; 201 had maintenance alone and 187 had consolidation followed by maintenance. The relapse rate was 60%; isolated central nervous system relapses were 8% of all CRs and 13% of all relapses. Median survival (overall survival [OS]), continuous complete remission (CCR), and disease-free survival (DFS) were 2.2, 2.4, and 2 years, respectively. PDN pretreatment response resulted the main independent factor influencing CR achievement, OS, CCR, and DFS; the addition of cyclophosphamide in induction significantly influenced CR achievement in a multivariate analysis. Neither induction intensification nor early consolidation appeared to influence CCR and DFS duration. For the first time PDN pretreatment response proved to be a powerful factor predicting disease outcome in adult ALL patients.
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            Epidemiology of childhood cancer in India.

            R. S. Arora, T Eden, G Kapoor (2015)
            There has been enormous progress in the treatment of childhood cancer in the developed world and the epidemiology in these countries is well described. Hitherto, there has been no attempt to systematically study the burden of childhood cancer in India or to understand how the occurrence and outcome of the disease varies across the country. We have reviewed the epidemiology (incidence, survival, and mortality) of childhood cancer across different population-based cancer registries in India and also compared it with data from the resource-rich countries. Incidence and mortality data were obtained from the National Cancer Registry Program Reports and the Cancer Incidence in 5 Continents publications. Further, a comprehensive review of medical literature was done for information on individual cancers as well as survival data. 1.6 to 4.8% of all cancer in India is seen in children below 15 years of age and the overall incidence of 38 to 124 per million children, per year, is lower than that in the developed world. The considerable inter-regional variation in incidence and mortality rates across India suggests a possible deficiency in ascertainment of cases and death notification, particularly in rural areas. The marked male preponderance of Hodgkin's disease, lower incidence of central nervous system tumors, and higher incidence of retinoblastoma merit further analysis.
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              The 2016 revision of WHO classification of myeloproliferative neoplasms: Clinical and molecular advances.

              T Barbui, J. Thiele, H Gisslinger … (2016)
              Clinical evidence supports the need of changing the diagnostic criteria of the 2008 updated WHO classification for polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). In JAK2-mutated patients who show characteristic bone marrow (BM) morphology, clinical studies demonstrated that a hemoglobin level of 16.5g/dL in men and 16.0g/dl for women or a hematocrit value of 49% in men and 48% in women are the optimal cut off levels for distinguishing JAK2-mutated ET from "masked/prodromal" PV. Therefore BM morphology was upgraded to a major diagnostic criterion. Regarding ET the key issue was to improve standardization of prominent BM features enhancing differentiation between "true" ET and prefibrotic/early primary myelofibrosis (prePMF). These two entities have shown a different epidemiology and clinical outcomes. Concerning prePMF a more explicit clinical characterization of minor criteria is mandated for an improved distinction from ET and overt PMF and accurate diagnosis and outcome prediction.
              Article 0 comments Cited 43 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Family Med Prim Care
                Journal ID (iso-abbrev): J Family Med Prim Care
                Journal ID (publisher-id): JFMPC
                Title: Journal of Family Medicine and Primary Care
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 2249-4863
                ISSN (Electronic): 2278-7135
                Publication date Collection: May 2020
                Publication date (Electronic): 31 May 2020
                Volume: 9
                Issue: 5
                Pages: 2309-2312
                Affiliations
                [1 ] Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
                [2 ] Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
                Author notes
                Address for correspondence: Dr. Lalit P. Meena, Associate Professor, Department of General Medicine, IMS, BHU, Varanasi - 221 005, Uttar Pradesh, India. E-mail: drlalitmeena@ 123456gmail.com
                Article
                Publisher ID: JFMPC-9-2309
                DOI: 10.4103/jfmpc.jfmpc_1245_19
                PMC ID: 7380823
                PubMed ID: 32754493
                SO-VID: 23b084b1-18e3-4bf4-8583-232b377dbbbf
                Copyright © Copyright: © 2020 Journal of Family Medicine and Primary Care
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 27 December 2019
                Date revision received : 10 February 2019
                Date accepted : 23 March 2020
                Categories
                Subject: Original Article

                Keywords: abo blood group,hematological malignancies,leukemia
                Data availability:
                Keywords: abo blood group, hematological malignancies, leukemia

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