Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?

Detalhes bibliográficos
Autor(a) principal: Warnakulsuriya, Nethmi Viranya
Data de Publicação: 2024
Outros Autores: Wanigasinghe, Dilini Nimeshi, Herath, Priyanka, Kottahachchi, Darshana
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Veras
DOI: 10.34117/bjdv10n4-041
Texto Completo: https://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/69027
Resumo: Background: Acute Lymphoblastic Leukemia (ALL) is a hematological malignancy that arises due to unusual proliferation of lymphoid precursor cells in bone marrow. Induction chemotherapy is vital for achieving complete remission in ALL, but accurately predicting relapse risk and identifying patients likely to sustain remission remains challenging. Conventionally, bone marrow lymphoblasts have been used as the gold standard for assessing treatment response and predicting relapse in ALL. However, emerging evidence suggests that bone marrow lymphocytes may serve as alternative predictive biomarkers. Aim: This study aims to review the utility of bone marrow lymphocytes as early predictors of relapse and remission in ALL during the post-induction chemotherapy phase. It will explore the advantages and limitations of assessing lymphocytes compared to lymphoblasts and discuss the potential mechanisms underlying their prognostic significance. Patients and Methods: Total of 105 newly diagnosed ALL patients; 75 with B ALL and 30 with T ALL was selected to the study. Laboratory investigations included Complete Blood Count (CBC) with the manual differential count analysis and obtaining bone marrow parameters from myelogram reports. The patients were followed until the end of the induction phase and, the laboratory parameters were taken. Correlation bivariate analysis, Paired sample t-Test was performed to establish the associations between peripheral blood parameters with the bone marrow parameters. Receiver operating characteristic (ROC) curve analysis was performed to establish cutoff values for peripheral blood parameters and the bone marrow lymphocytes with aiming to investigate bone marrow response. All the analysis was performed using Microsoft Excel 2013.12 SPSS version 26. Results: In B ALL at Day 8, Lymphocytes% in Bone Marrow (L%_BM) showed a significant strong negative correlation (r =-0.357, p<0.05) with NLR. ROC curve analysis showed cut off values for Lymphocytes; NLR =<0.400 indicates the presence of L%_BM >10% in B ALL. When considering T ALL D8, the ALC>=1756/mm3 suggests the presence of >10% L%_BM in D8. Conclusion: Our research demonstrated strong correlations to predict the Lymphoblasts% in Bone Marrow (BL%_BM) & L%_BM by using peripheral blood parameters which is straight forward and easily obtainable. Moreover, we were successfully able to set up cut off peripheral blood parameter values to monitor the response of the Lymphocytes of the bone marrow. Before implementing the results, further studies could be carried out by increasing the sample size for both B & T ALL with the accurate monitoring of the patients.
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spelling Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?Acute Lymphoblastic Leukemiacomplete blood countinduction chemotherapybone marrow lymphoblastbone marrow lymphocytesBackground: Acute Lymphoblastic Leukemia (ALL) is a hematological malignancy that arises due to unusual proliferation of lymphoid precursor cells in bone marrow. Induction chemotherapy is vital for achieving complete remission in ALL, but accurately predicting relapse risk and identifying patients likely to sustain remission remains challenging. Conventionally, bone marrow lymphoblasts have been used as the gold standard for assessing treatment response and predicting relapse in ALL. However, emerging evidence suggests that bone marrow lymphocytes may serve as alternative predictive biomarkers. Aim: This study aims to review the utility of bone marrow lymphocytes as early predictors of relapse and remission in ALL during the post-induction chemotherapy phase. It will explore the advantages and limitations of assessing lymphocytes compared to lymphoblasts and discuss the potential mechanisms underlying their prognostic significance. Patients and Methods: Total of 105 newly diagnosed ALL patients; 75 with B ALL and 30 with T ALL was selected to the study. Laboratory investigations included Complete Blood Count (CBC) with the manual differential count analysis and obtaining bone marrow parameters from myelogram reports. The patients were followed until the end of the induction phase and, the laboratory parameters were taken. Correlation bivariate analysis, Paired sample t-Test was performed to establish the associations between peripheral blood parameters with the bone marrow parameters. Receiver operating characteristic (ROC) curve analysis was performed to establish cutoff values for peripheral blood parameters and the bone marrow lymphocytes with aiming to investigate bone marrow response. All the analysis was performed using Microsoft Excel 2013.12 SPSS version 26. Results: In B ALL at Day 8, Lymphocytes% in Bone Marrow (L%_BM) showed a significant strong negative correlation (r =-0.357, p<0.05) with NLR. ROC curve analysis showed cut off values for Lymphocytes; NLR =<0.400 indicates the presence of L%_BM >10% in B ALL. When considering T ALL D8, the ALC>=1756/mm3 suggests the presence of >10% L%_BM in D8. Conclusion: Our research demonstrated strong correlations to predict the Lymphoblasts% in Bone Marrow (BL%_BM) & L%_BM by using peripheral blood parameters which is straight forward and easily obtainable. Moreover, we were successfully able to set up cut off peripheral blood parameter values to monitor the response of the Lymphocytes of the bone marrow. Before implementing the results, further studies could be carried out by increasing the sample size for both B & T ALL with the accurate monitoring of the patients.Brazilian Journals Publicações de Periódicos e Editora Ltda.2024-04-18info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/6902710.34117/bjdv10n4-041Brazilian Journal of Development; Vol. 10 No. 4 (2024); e69027Brazilian Journal of Development; Vol. 10 Núm. 4 (2024); e69027Brazilian Journal of Development; v. 10 n. 4 (2024); e690272525-8761reponame:Revista Verasinstname:Instituto Superior de Educação Vera Cruz (VeraCruz)instacron:VERACRUZenghttps://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/69027/49280Warnakulsuriya, Nethmi ViranyaWanigasinghe, Dilini NimeshiHerath, PriyankaKottahachchi, Darshanainfo:eu-repo/semantics/openAccess2024-05-15T16:36:36Zoai:ojs2.ojs.brazilianjournals.com.br:article/69027Revistahttp://site.veracruz.edu.br:8087/instituto/revistaveras/index.php/revistaveras/PRIhttp://site.veracruz.edu.br:8087/instituto/revistaveras/index.php/revistaveras/oai||revistaveras@veracruz.edu.br2236-57292236-5729opendoar:2024-10-15T16:28:10.659978Revista Veras - Instituto Superior de Educação Vera Cruz (VeraCruz)false
dc.title.none.fl_str_mv Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
title Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
spellingShingle Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
Warnakulsuriya, Nethmi Viranya
Acute Lymphoblastic Leukemia
complete blood count
induction chemotherapy
bone marrow lymphoblast
bone marrow lymphocytes
Warnakulsuriya, Nethmi Viranya
Acute Lymphoblastic Leukemia
complete blood count
induction chemotherapy
bone marrow lymphoblast
bone marrow lymphocytes
title_short Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
title_full Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
title_fullStr Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
title_full_unstemmed Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
title_sort Bone Marrow Lymphocytes: can they be an alternative for Bone Marrow Lymphoblasts as early predictors of relapse and remission in Acute Lymphoblastic Leukemia at the post-Induction chemotherapy phase?
author Warnakulsuriya, Nethmi Viranya
author_facet Warnakulsuriya, Nethmi Viranya
Warnakulsuriya, Nethmi Viranya
Wanigasinghe, Dilini Nimeshi
Herath, Priyanka
Kottahachchi, Darshana
Wanigasinghe, Dilini Nimeshi
Herath, Priyanka
Kottahachchi, Darshana
author_role author
author2 Wanigasinghe, Dilini Nimeshi
Herath, Priyanka
Kottahachchi, Darshana
author2_role author
author
author
dc.contributor.author.fl_str_mv Warnakulsuriya, Nethmi Viranya
Wanigasinghe, Dilini Nimeshi
Herath, Priyanka
Kottahachchi, Darshana
dc.subject.por.fl_str_mv Acute Lymphoblastic Leukemia
complete blood count
induction chemotherapy
bone marrow lymphoblast
bone marrow lymphocytes
topic Acute Lymphoblastic Leukemia
complete blood count
induction chemotherapy
bone marrow lymphoblast
bone marrow lymphocytes
description Background: Acute Lymphoblastic Leukemia (ALL) is a hematological malignancy that arises due to unusual proliferation of lymphoid precursor cells in bone marrow. Induction chemotherapy is vital for achieving complete remission in ALL, but accurately predicting relapse risk and identifying patients likely to sustain remission remains challenging. Conventionally, bone marrow lymphoblasts have been used as the gold standard for assessing treatment response and predicting relapse in ALL. However, emerging evidence suggests that bone marrow lymphocytes may serve as alternative predictive biomarkers. Aim: This study aims to review the utility of bone marrow lymphocytes as early predictors of relapse and remission in ALL during the post-induction chemotherapy phase. It will explore the advantages and limitations of assessing lymphocytes compared to lymphoblasts and discuss the potential mechanisms underlying their prognostic significance. Patients and Methods: Total of 105 newly diagnosed ALL patients; 75 with B ALL and 30 with T ALL was selected to the study. Laboratory investigations included Complete Blood Count (CBC) with the manual differential count analysis and obtaining bone marrow parameters from myelogram reports. The patients were followed until the end of the induction phase and, the laboratory parameters were taken. Correlation bivariate analysis, Paired sample t-Test was performed to establish the associations between peripheral blood parameters with the bone marrow parameters. Receiver operating characteristic (ROC) curve analysis was performed to establish cutoff values for peripheral blood parameters and the bone marrow lymphocytes with aiming to investigate bone marrow response. All the analysis was performed using Microsoft Excel 2013.12 SPSS version 26. Results: In B ALL at Day 8, Lymphocytes% in Bone Marrow (L%_BM) showed a significant strong negative correlation (r =-0.357, p<0.05) with NLR. ROC curve analysis showed cut off values for Lymphocytes; NLR =<0.400 indicates the presence of L%_BM >10% in B ALL. When considering T ALL D8, the ALC>=1756/mm3 suggests the presence of >10% L%_BM in D8. Conclusion: Our research demonstrated strong correlations to predict the Lymphoblasts% in Bone Marrow (BL%_BM) & L%_BM by using peripheral blood parameters which is straight forward and easily obtainable. Moreover, we were successfully able to set up cut off peripheral blood parameter values to monitor the response of the Lymphocytes of the bone marrow. Before implementing the results, further studies could be carried out by increasing the sample size for both B & T ALL with the accurate monitoring of the patients.
publishDate 2024
dc.date.none.fl_str_mv 2024-04-18
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/69027
10.34117/bjdv10n4-041
url https://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/69027
identifier_str_mv 10.34117/bjdv10n4-041
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/69027/49280
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Brazilian Journals Publicações de Periódicos e Editora Ltda.
publisher.none.fl_str_mv Brazilian Journals Publicações de Periódicos e Editora Ltda.
dc.source.none.fl_str_mv Brazilian Journal of Development; Vol. 10 No. 4 (2024); e69027
Brazilian Journal of Development; Vol. 10 Núm. 4 (2024); e69027
Brazilian Journal of Development; v. 10 n. 4 (2024); e69027
2525-8761
reponame:Revista Veras
instname:Instituto Superior de Educação Vera Cruz (VeraCruz)
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instname_str Instituto Superior de Educação Vera Cruz (VeraCruz)
instacron_str VERACRUZ
institution VERACRUZ
reponame_str Revista Veras
collection Revista Veras
repository.name.fl_str_mv Revista Veras - Instituto Superior de Educação Vera Cruz (VeraCruz)
repository.mail.fl_str_mv ||revistaveras@veracruz.edu.br
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dc.identifier.doi.none.fl_str_mv 10.34117/bjdv10n4-041