Analysis of Full Blood Count and Bone Marrow Aspirations at Presentation in Children Diagnosed with Acute Leukaemias – A Single Centre Experience in Southern Nigeria

Main Article Content

G. K. Eke
K. I. Korubo


Introduction: Acute leukaemias are the most common malignant neoplasms in childhood, presenting with a variety of nonspecific symptoms. Though many of the recent more sophisticated methods of diagnosis have important prognostic implications, they are often not available in low- and middle-income countries.

Objective: To review the full blood count and bone marrow aspirations at presentation in children diagnosed with acute leukaemias at a teaching hospital in southern Nigeria.

Methodology: A retrospective survey of children with acute leukaemias admitted into the Paediatric Oncology unit of the University of Port Harcourt Teaching Hospital (UPTH), from January 2014 to December 2020. Their clinical profile, full blood count and bone marrow aspirations were analyzed using SPSS version 25.0

Results: Forty-three children aged 8 months to 17 years, with a median age of 9 years, were diagnosed with acute leukaemia within the period under review, 28 (65.1%) were males and 15 (34.9%) females, giving a M:F ratio of 1.9:1. Commonest clinical features at presentation were fever (n=28, 65.1%), pallor (n=18, 41.9%) and gum bleeding (n=16, 37.2%); while 38 (88.4%) of them presented with anaemia, 20 (46.5%) had leukocytosis and 36 (83.7%) had thrombocytopoenia with a median platelet count of 42x109/L and circulating blasts were present in the peripheral blood film of most of the patients. Acute lymphoblastic leukaemia (ALL) was the diagnosis in 30 (70%) children, and AML in 9 (21%). The bone marrow was hypercellular in 30 cases (69.8%) and erythropoiesis was depressed in 39 (90.7%) children.

Conclusion: At the UPTH, children with acute leukaemias were mostly males. Fever, pallor and gum bleeding were the commonest symptoms with most of them having circulating blasts. Acute lymphoblastic leukaemia was the commonest type and bone marrow was mainly hypercellular with depressed erythropoiesis.

Full blood count, Bone marrow aspiration, Children, Acute leukaemia, Southern Nigeria

Article Details

How to Cite
Eke, G. K., & Korubo, K. I. (2021). Analysis of Full Blood Count and Bone Marrow Aspirations at Presentation in Children Diagnosed with Acute Leukaemias – A Single Centre Experience in Southern Nigeria. Journal of Cancer and Tumor International, 11(2), 1-8.
Original Research Article


Cancer Stat Facts: Childhood Leukemia (Ages 0-19); 2021.
Accessed on 15th Jan 2021

Tubergen DG, Bleyer A, Ritchey AK, Friehling E. The leukemias. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of Paediatrics. 20th Edition, Philadelphia. Elsevier. 2016;2437-2443.

Bunyatisai W, Jia-Mahasap B, Chitapanarux I. Treatment Outcomes of Acute Lymphoblastic Leukemia in both children and adults using the Thai Pediatric Oncology Group-based protocol at Chiang Mai University hospital Jornal of Thai Association of Radiation Oncology. 2019; 25(1):12-28.

American childhood cancer organization. Childhood cancer statistics. ACCO; 2020.

Eke GK, Ugwueze N, Akani NA. Childhood Cancers in a Tertiary Centre, Southern Nigeria: Spectrum and Outcome of Treatment. Journal of Cancer and Tumor International. 2021;11(1):25-34.

Togo B, Traore F, Doumbia AK, Togo P, Diall H, Maiga B et al. Childhood acute lymphoblastic leukemia in sub Saharan Africa: 4 years’ experience at the pediatric oncology unit Bamako, Mali. J Child Adolesc Health. 2018;2(2):45-47.

Oyesakin AB, Nwatah VE, Ukpai NU, David EI, Wakama TT, Oniyangi O. Pattern of childhood acute leukemia presentation at a tertiary hospital in Nigeria: a five-year review. Int J Contemp Pediatr. 2018;5(6):2123-2128.

American Cancer Society. About Childhood Leukemia. | 1.800.22 7.2345;2019.

Rabin KR, Gramatges MM, Margolin JF, Poplack DG. Chapter 19: Acute Lymphoblastic Leukemia. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2016.

Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the acute leukaemias (FAB cooperative group). Brj Haematol. 1976;33:451-458.

White NJ. Anaemia and malaria. Malaria Journal. 2018;17:371.

Ladu AI, Abba AM, Talba H, Kundili Y, Abba Kawu Y, Tukur RA. Paraplegia as initial presentation of acute myeloid leukemia: A case report. Int J Case Rep Images. 2017;8(11):703–706.

Teke HU, Cansu DU, Yildiz P, Temiz G, Bal C. Clinical significance of serum IL-6, TNF-α, Hepcidin, and EPO levels in anaemia of chronic disease and iron deficiency anaemia: The laboratory indicators for anaemia. Biomedical Research. 2017;28(6):2704-2710.

Ochicha O, Gwarzo AK, Gwarzo D. Pediatric malignancies in Kano, Northern Nigeria. World J Pediatr. 2012;8(3):235-9.

Gamal Abdul-Hamid. Classification of Acute Leukemia, Acute Leukemia - The Scientist's Perspective and Challenge, Mariastefania Antica, IntechOpen; 2011.
DOI: 10.5772/19848.

Arber DA, Orazi A, Hasserjian R, et al. The revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20): 2391-2405.