Page 234 - Abstract Book KONIKA 18

Hemato-Oncology

P-HO-013
Complete Blood Count and Peripheral Blood Smear Pattern
in Diagnosis of Leukemia

Diah Kusuma Arumsari, Andi Cahyadi
Division of Hematology Oncology, Department of Child Health, Dr. Soetomo General Hospital,
Surabaya, East Java, Indonesia

Abstract
Background Leukemia is the most common malignancy of childhood, accounting for 30% cases of
childhood cancer. Leukemia causes impaired production of normal erythrocyte, leukocytes, and thrombocyte.
Objective To evaluate the characteristic of complete blood count (CBC) and peripheral blood smear (PBS)
in leukemia pediatric patients. Methods This cross-sectional study evaluated CBC and PBS (taken before
bone marrow aspiration) of leukemia pediatric patients at Hematology Oncology Ward, Dr. Soetomo General
Hospital Surabaya, from January to June 2021. Leukemia subtypes were acute lymphoblastic leukemia
(ALL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (CML). PBS described
the morphology of erythrocyte, leukocyte, and thrombocyte. CBC was described as median, minimum and
maximum value. Results Samples were 65 patients, consist of 63.1% males and 36.9% females; 76.9%
aged 1-10 and 23.1% aged above 10. The PBS showed normochromic normocytic erythrocytes in 85.2%
(ALL), 100% (AML), 80% (CML) patients. Increased leukocytes in 42.6% (ALL), 83.4% (AML), 100%
(CML) patients. Blast cells present in 72.2% (ALL), 83.4% (AML), 100% (CML) patients. Decreased
thrombocyte in 96.3% (ALL), 100% (AML) but increased in 60% (CML) patients. The CBC median
of hemoglobin (g/dL) were 9.4 (ALL), 9.6 (AML), 8.6 (CML); leukocyte (103/uL) were 10.68 (ALL),
76.32 (AML), 340.57 (CML); and thrombocyte (103/uL) were 29.5 (ALL), 38 (AML), 227 (CML).
Conclusion Leukemia is commonly found in male, aged 0-10 years old. ALL is the most common. PBS
pattern mostly are normochromic normocytic erythrocytes, leukocytes increased, blasts present, thrombocyte
decreased or increased. CBC mostly show anemia, leukocytosis or hyperleukocytosis, and thrombocytopenia.
Keywords: pediatric cancer; leukemia, peripheral blood smear; complete blood count

P-HO-014
Hemorrhagic Stroke Secondary to Iron Deficiency Anemia: A Case Report

Agus Fitrianto, Kanthi Soraca Widiatmika, Trivani Putri, Haryanti Fauzia Wulandari, Murti Andriastuti
Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia,
Jakarta, Indonesia

Abstract
Background Iron deficiency anemia (IDA) represents the most common cause of anemia in childhood. Studies
have reported association between IDA and hemorrhagic stroke (HS). This may be explained by decreased
platelet aggregation due to hypoferritinemia. Literatures reported aproximatelyly 25% children with HS will
die and 42% of those who survive present with significant disability. Objective To demonstrate hemorrhagic
stroke as complication of decreased platelet aggregation in children with IDA. Case A 14-year-old girl
presented with vertigo along with double vision, nausea, and vomiting. Upon arrival to hospital, she was
alert with right dysmetria. On examination, anemic conjunctiva was found and she was wasted. There were
no jaundice and organomegaly. No history of head trauma, fever, drastic weight loss, seizures, and similar
complaints in the past. No history of menometrorrhagia. She rarely consume iron-rich foods. Laboratory
analysis reported Hb level 10.7, RetHe level 21.10, thrombocytosis, leucocytosis, and decreased platelet
aggregation. Peripheral blood smear showed hypochromic microcytic and iron profile indicated IDA with
ferritin and transferrin level are <1.00 ng/mL and 4%. Magnetic resonance imaging (MRI) showed subacute
cerebellar haemorrhage. Intracranial vessels were normal based on CT angiography. Oral iron supplements
was prescribed 4mg/kg/day for 3 months. Post-therapy laboratory examination showed improvement in
Hb level, erytthrocyte index, platelet agregation and iron status. There were no sequelae in patient after
physiotherapy programs. Conclusion IDA should be considered as significant risk factor in children with
stroke. Early diagnosis and adequate treatment can prevent neurological deficit and death.
Keywords: stroke; iron deficiency anemia; platelet agregation

186 KONIKA XVIII Abstract Book