Spectrum of Complications in Patients of Acute Leukemia- A Regional Study from Pgims, Rohtak

Objectives: This study was conducted to determine the spectrum of complications in patients of acute leukemia.

Materials and Methods: The present study was conducted at Pandit Bhagwat Dayal Sharma Post

Graduate Institute of Medical Sciences, Rohtak and data was collected from patients who presented with confirmed diagnosis of acute leukemia over a period of one year. Patients satisfying inclusion criteria were monitored for development of any complications. Baseline parameters were recorded on admission and then every 7 days interval till remission. Data were analyzed by statistical package for social sciences (SPSS) version16.0.

Results: The data was collected from 35 patients. Most common presenting complaint was fever in 88.6% of patients. AML was diagnosed in 16 patients (45.7%) and rest had ALL (54.2%). In our study about 25% of patients had bleeding symptoms at presentations and almost 100% of patients developed bleeding complications during induction therapy. Most common sites of bleeding in our study was cutaneous bleed (100%) followed by gum bleed (26.4%). Life threatening bleeding in form of intracranial bleed was noted in 4 patients of which 3 patients died of bleeding complications amounting to 27.2%. Among 34 patients twenty two patients (64.7%) had neutropenia. Infectious complications were the second most common complication noted in our study. Most common infectious complication was pneumonia seen in 25.9% of febrile patients followed by blood stream infection (18.5%). An infectious etiology was documented in 33.3% of patients with frequency of gram negative and gram positive infections was 88.9% and 11.1% respectively. Pseudomonas sp was the most commonly (44.4%) isolated micro-organism. Among patients with pneumonia fungal etiology was identified in 71.4% of patients making IFIs one of the most frequent infectious complications in acute leukemia patients. In our study 18.7 % of patients developed TLS, all patients had Laboratory TLS and only one patient had Clinical TLS. One patient developed L-asparaginase induced acute pancreatitis and one patient developed differentiation syndrome.

Conclusion: Acute leukemia is a devastating disease with wide spectrum of complications not only related to disease part but also because of its treatment