Blood work of my 9-year-old son showed low Hb and acute lymphoblastic leukemia. Please help.

Hello,

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Based on the provided history and reports (attachment removed to protect patient identity), it seems to be a hemolytic anemia case. The cause for hemolytic anemia should be searched. Dengue also should be ruled out by IgM ELISA (enzyme-linked immunosorbent assay) test and NS1 (nonstructural protein 1) antigen test. Spleen is also enlarged. So, most probably it is hemolytic anemia. Elevated bilirubin also favors diagnosis. He needs to visit the hematologist for a detailed physical examination, and accordingly, management can be planned. In hemolytic anemia, RBC (red blood cells) are getting destructed. Autoimmune hemolytic anemia, G6PD (glucose-6-phosphate dehydrogenase) deficiency, PNH (paroxysmal nocturnal hemoglobinuria) hemoglobinopathy, and spherocytosis are some of the causes of hemolytic anemia. To increase hemoglobin and platelet, blood transfusion is needed.

I hope this helps you.

Thank you.

Hello,

Welcome back to icliniq.com.

There is a presence of low hemoglobin and low platelets. If the hematologist does not find any cause for hemolytic anemia, then further workup should be done to exclude leukemia and myeloproliferative disorder. Bone marrow biopsy for your child can be planned for further workup. Bone marrow biopsy is a gold standard test to exclude all blood cancer. Therefore, discuss with the hematologist about planning for bone marrow biopsy. In the attached report (attachment removed to protect patient identity), no abnormal malignant cells are present. So, leukemia cannot be ruled out from the CBC (complete blood count) report only. To exclude leukemia, I suggest bone marrow biopsy or flow cytometry like a higher investigation. There is the possibility of leukemia as well when bicytopenia present.

I hope this helps you.

Thank you.

Hello,

Welcome back to icliniq.com.

The attached report shows B cell acute lymphoblastic leukemia (attachment removed to protect patient identity). So, your doctor is right. He is having ALL type of blood cancer. Therefore, I suggest he should be put on treatment for ALL. Prognosis is very good in children, and remission occurs in most cases. I am sorry, he has blood cancer. But do not worry. Prognosis and ten year survival rate are good for this type of blood cancer. I suggest you start treatment after a physical examination by a hematologist.

I hope you are satisfied with my answer. For further queries, you can consult me at icliniq.

Thank you.

Hello,

Welcome back to icliniq.com.

Following is my opinion for your asked question. I am sorry to hear that the kid has leukemia, which means blood cancer. In the attached reports, there are three CBC (complete blood count) reports, but they are not conclusive in ruling out leukemia. Therefore, bone marrow aspiration and flow cytometry are suggested. Now, note the following important positive findings:

1. The liver and spleen are enlarged.
2. In the bone marrow, 74 percent blast cells are mentioned.
3. Flow cytometry shows an ALL (acute lymphoblastic leukemia) picture.
4. With more than 20 percent blast cells in the bone marrow or smear and enlarged liver and spleen, this is highly suggestive of blood cancer. Considering all the reports, it is indicative of ALL type of blood cancer.

You can consult a hematologist or hematology oncologist nearby to begin treatment. But do not worry, the prognosis and ten-year survival rate are good for this type of blood cancer

Hope I have answered your doubt and question. Let me know if you have more questions in mind.

Thank you.