Hematological and Clinical Profiles Associated with Leukemia Outcomes in Children at West Nusa Tenggara Hospital
DOI:
10.29303/jbt.v26i4.13410Published:
2026-10-01Downloads
Abstract
Leukemia is a hematologic malignancy characterized by abnormal proliferation of leukocytes. Hematological and clinical profiles may influence leukemia outcomes; however, information regarding their association with outcomes in pediatric leukemia patients in West Nusa Tenggara Province remains limited. To determine the association between hematological and clinical profiles and leukemia outcomes in children at the Regional General Hospital of West Nusa Tenggara Province. This quantitative observational analytic study used a cross-sectional design involving pediatric leukemia patients aged 0–18 years diagnosed between April 2024 and October 2025. Patients were selected using total sampling from medical records. Hematological variables included erythropenia, thrombocytopenia, leukocyte count, and anemia, while clinical variables included fever, bleeding, pallor, hepatomegaly, lymphadenopathy, splenomegaly, and bone or joint pain. Of 65 eligible patients, 51 were included; 52.9% had acute lymphoblastic leukemia, 29.4% acute myeloid leukemia, and 17.6% chronic myeloid leukemia. Thirty-eight patients (74.5%) received chemotherapy. The most common findings were erythropenia (80%), thrombocytopenia (82.3%), anemia (82.3%), pallor (68.6%), and splenomegaly (66.7%). In the therapy group, thrombocytopenia (p = 0.016), bleeding (p = 0.037), and bone or joint pain (p = 0.038) were significantly associated with outcomes. In the non-therapy group, only bone or joint pain was significantly associated with outcomes (p = 0.029). Thrombocytopenia, bleeding, and bone or joint pain were associated with outcomes among patients receiving therapy, while bone or joint pain was associated with outcomes among non-therapy patients.
Keywords:
Clinical Profile Chemotherapy Hematological Profile Leukemia Pediatric Leukemia Treatment OutcomeReferences
Abdulgayoom, M., Al-Asa'd, Y., Ali, A., Al-Mashdali, A. F., Shawaylia, H., Soliman, D. S., Mudawi, D., Abbas, F., Almokdad, O., Ellahie, A., Cherif, H., & Mohamed, S. (2025). High-risk bleeding in acute myeloid leukemia: Clinical presentation, laboratory markers, and mortality trends. Clinical and Applied Thrombosis/Hemostasis, 31, 1–9. https://doi.org/10.1177/10760296251405424
Ahn, M. B., & Suh, B. K. (2020). Bone morbidity in pediatric acute lymphoblastic leukemia. Annals of Pediatric Endocrinology & Metabolism, 25(1), 1–9. https://doi.org/10.6065/apem.2020.25.1.1
Amalia, C., & Hanggara, D. S. (2021). Hubungan profil hematologi dengan luaran pascakemoterapi fase induksi pada anak leukemia limfoblastik akut. CHMK Health Journal, 5(1), 269–273. http://cyberchmk.net/ojs/index.php/kesehatan/article/view/970/346
Angelia, A. (2024). Eksplorasi aspek sosial budaya pasien kanker yang menolak kemoterapi di Rumah Sakit Umum Raden Mattaher Jambi [Preprint]. e-Skripsi Universitas Andalas.
Chennamadhavuni, A., Iyengar, V., Mukkamalla, S. K. R., & Shimanovsky, A. (2023). Leukemia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560490/
Clarke, R. T., Van den Bruel, A., Bankhead, C., Mitchell, C. D., Phillips, B., & Thompson, M. J. (2016). Clinical presentation of childhood leukaemia: A systematic review and meta-analysis. Archives of Disease in Childhood, 101(10), 894–901. https://doi.org/10.1136/archdischild-2016-311251
Daltveit, D. S., Morgan, E., Colombet, M., Steliarova-Foucher, E., Bendahhou, K., Marcos-Gragera, R., Rongshou, Z., Smith, A., Wei, H., & Soerjomataram, I. (2025). Global patterns of leukemia by subtype, age, and sex in 185 countries in 2022. Leukemia, 39(2), 412–419. https://doi.org/10.1038/s41375-024-02452-y
Duarte-Rodríguez, D. A., Flores-Lujano, J., McNally, R. J. Q., Pérez-Saldivar, M. L., Jiménez-Hernández, E., Martín-Trejo, J. A., Espinoza-Hernández, L. E., Medina-Sanson, A., Paredes-Aguilera, R., Merino-Pasaye, L. E., Velázquez-Aviña, M. M., Torres-Nava, J. R., Espinosa-Elizondo, R. M., Amador-Sánchez, R., Dosta-Herrera, J. J., Mondragón-García, J. A., González-Ulibarri, J. E., Martínez-Silva, S. I., Espinoza-Anrubio, G., ... Mejía-Aranguré, J. M. (2024). Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: Report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia. Frontiers in Oncology, 14, 1304633. https://doi.org/10.3389/fonc.2024.1304633
Greaves, M. (2018). A causal mechanism for childhood acute lymphoblastic leukaemia. Nature Reviews Cancer, 18, 471–484. https://doi.org/10.1038/s41568-018-0015-6
Hasan, A. S. M. D., Mollah, D. H., Hossain, M. M., Aronee, N. S., & Khandakar, T. (2024). Clinical presentation of leukemia in children. Bangladesh Medical Journal, 53(2). https://doi.org/10.3329/bmj.v53i2.83411
Hossain, M. J., Xie, L., & McCahan, S. M. (2014). Characterization of pediatric acute lymphoblastic leukemia survival patterns by age at diagnosis. Journal of Cancer Epidemiology, 2014, 865979. https://doi.org/10.1155/2014/865979
Kang, S., Im, H. J., Bae, K., & Park, S.-S. (2017). Influence of musculoskeletal manifestations as the only presenting symptom in B-cell acute lymphoblastic leukemia. The Journal of Pediatrics, 182, 290–295.e1. https://doi.org/10.1016/j.jpeds.2016.11.072
Kittivisuit, S., Sripornsawan, P., Songthawee, N., Chavananon, S., McNeil, E. B., & Chotsampancharoen, T. (2022). Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes. Pediatric Rheumatology, 20, 34. https://doi.org/10.1186/s12969-022-00692-9
Liu, W., Fang, J., Zhu, M., Zhou, J., & Yuan, C. (2025). Global, regional, and national burden of childhood leukemia from 1990 to 2021. BMC Pediatrics, 25, 571. https://doi.org/10.1186/s12887-025-05847-7
Mehrbakhsh, Z., Hassanzadeh, R., Behnampour, N., Tapak, L., Zarrin, Z., Khazaei, S., & Dinu, I. (2024). Machine learning-based evaluation of prognostic factors for mortality and relapse in patients with acute lymphoblastic leukemia: A comparative simulation study. BMC Medical Informatics and Decision Making, 24, 261. https://doi.org/10.1186/s12911-024-02645-6
Melati, G. P. (2025). Gambaran profil hematologi pada pasien leukemia limfoblastik akut (LLA) di RSUD Dr. H. Abdul Moeloek Provinsi Lampung tahun 2023 [Karya ilmiah]. Poltekkes Kemenkes Tanjung Karang.
National Cancer Institute. (2025). Childhood acute lymphoblastic leukemia treatment (PDQ®)—Patient version. https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq
Rahmat, R., Tjong, D. H., Almurdi, A., & Wulandari, M. (2022). Nilai leukosit, eritrosit dan trombosit pada penderita leukemia limfoblastik akut pasien anak. Jurnal Kesehatan Perintis, 9(2), 76–81. https://doi.org/10.33653/jkp.v9i2.863
Rompies, R., Amelia, S. P., & Gunawan, S. (2020). Perubahan status gizi pada anak dengan leukemia limfoblastik akut selama terapi. e-CliniC, 8(1). https://doi.org/10.35790/ecl.8i1.28290
Tewuh, S., Mantik, M. F., & Warouw, S. M. (2016). Hubungan kadar hemoglobin dengan peluang remisi pada anak penderita leukemia limfoblastik akut periode 2010–2014 di RSUP Prof. Dr. R. D. Kandou Manado. e-CliniC, 4(2). https://doi.org/10.35790/ecl.v4i2.12728
Williams, S., & Rose, A. (2022). Childhood leukemia with musculoskeletal characteristics. Clinics in Mother and Child Health, 19(S13), 398. https://doi.org/10.35248/2090-7214.22.19.398
Zhang, A.-L., Chen, X.-J., Zou, Y., Yang, W.-Y., Guo, Y., Wang, S.-C., Zhang, L., Liu, X.-M., Ruan, M., Liu, T.-F., Qi, B.-Q., & Zhu, X.-F. (2019). Clinical features and prognosis of children with acute lymphoblastic leukemia and different platelet levels. Chinese Journal of Contemporary Pediatrics, 21(8), 766–771. https://doi.org/10.7499/j.issn.1008-8830.2019.08.006
Zhang, L., Liu, J., Qin, X., & Liu, W. (2022). Platelet–acute leukemia interactions. Clinica Chimica Acta, 536, 29–38. https://doi.org/10.1016/j.cca.2022.09.015
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