PRETREATMENT LABORATORY PARAMETERS AS POTENTIAL EARLY BIOMARKERS FOR DISEASE AGGRESSIVENESS IN ACUTE LEUKEMIA

Muna Mohammed Hassan, Gamal Abdul Hamid

ABSTRACT

Background:
In ac ute leukemia, early identification of aggressive disease is crucial for risk adapted therapy.
Pretreatment laboratory parameters, readily available at diagnosis, may reflect underlying tumor burden and
metabolic stress. Objective: To evaluate a panel of ro utine hematological and biochemical parameters as potential
biomarkers of disease aggressiveness in patients with acute leukemia prior to induction chemotherapy.
Methods: We conducted a retrospective analysis of 30 patients with newly diagnosed acute lymph oblastic
leukemia (ALL) or acute myeloid leukemia (AML). Data included complete blood counts and liver function tests.
A simple "High Risk Presentation Score" (HRPS) was devised, assigning one point each for: leukocytosis (WBC
>50 × 10 ⁶ /L), severe thrombocytopenia (platelets <50 × 10⁶/L), hypoalbuminemia (albumin <3.5 g/dL), and
transaminitis (ALT or AST >40 U/L). A score ≥2 defined a high risk phenotypic cluster. Results: The cohort
comprised 18 AML and 12 ALL patients, with a median a ge of 24 years (range: 1 85). Abnormalities were
common: severe thrombocytopenia in 20 (66.7%), transaminitis in 13 (43.3%), leukocytosis >50 in 9 (30%), and
hypoalbuminemia in 12 (40%). Based on the HRPS, 14 patients (46.7%) were classified as high risk ( score ≥2).
This high risk group exhibited a higher median WBC count (68 vs. 16 × 10⁶/L) and lower median platelet count
(18.5 vs. 71 × 10⁶/L) compared to the low risk group. Conclusion: A composite score integrating easily available
pretreatment lab values can identify a distinct subgroup of acute leukemia patients with features suggestive of high
disease burden and metabolic derangement. This pragmatic tool may aid in early risk stratification and warrants
prospective validation against clinical outcomes s uch as chemotherapy tolerance and early mortality.

Keywords: KEYWORDS: Acute leukemia, Biomarkers, Risk stratification, Laboratory parameters, Prognosis.