Bone pain as an initial symptom of childhood acute lymphoblastic leukemia: Association with nearly normal hematologic indexes

Olafur G. Jonsson, Peggy Sartain, Jonathan M. Ducore, George R. Buchanan

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

We reviewed the records of all patients with a diagnosis of ALL made at our center during a 13-year period to determine the relationship between bone pain and the hematologic findings at diagnosis of acute lymphoblastic leukemia. Of 296 eligible patients, 179 (60%) had no bone pain (group 1), 65 (22%) had some bone pain (group 2), and 52 (18%) had prominent bone pain that overshadowed other manifestations of the leukemia (group 3). Statistically significant differences were found between the groups for hemoglobin concentration (p<0.001), leukocyte count (p=0.014), absolute neutrophil count (p=0.002), percentage of circulating blast cells (p=0.009), and platelet count (p<0.001). Children in group 3 had values closer to normal for all these values than those of patients in the other groups. Group 3 patients had symptoms an average of more than 2 weeks longer before diagnosis, and had significantly lower serum uric acid and higher calcium levels than patients in the other groups had. No differences were detected among the groups in age at diagnosis, gender, or survival rate. We conclude that children with acute lymphoblastic leukemia who have prominent bone pain preceding the diagnosis frequently have nearly normal hematologic values and that this feature may contribute to a delay in diagnosis.

Original languageEnglish (US)
Pages (from-to)233-237
Number of pages5
JournalThe Journal of Pediatrics
Volume117
Issue number2 PART 1
DOIs
StatePublished - 1990

Fingerprint

Precursor Cell Lymphoblastic Leukemia-Lymphoma
Bone and Bones
Pain
Reference Values
Uric Acid
Platelet Count
Leukocyte Count
Leukemia
Hemoglobins
Neutrophils
Survival Rate
Age Groups
Calcium
Serum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Bone pain as an initial symptom of childhood acute lymphoblastic leukemia : Association with nearly normal hematologic indexes. / Jonsson, Olafur G.; Sartain, Peggy; Ducore, Jonathan M.; Buchanan, George R.

In: The Journal of Pediatrics, Vol. 117, No. 2 PART 1, 1990, p. 233-237.

Research output: Contribution to journalArticle

@article{2e872a999024426983f4d13f73a7afec,
title = "Bone pain as an initial symptom of childhood acute lymphoblastic leukemia: Association with nearly normal hematologic indexes",
abstract = "We reviewed the records of all patients with a diagnosis of ALL made at our center during a 13-year period to determine the relationship between bone pain and the hematologic findings at diagnosis of acute lymphoblastic leukemia. Of 296 eligible patients, 179 (60{\%}) had no bone pain (group 1), 65 (22{\%}) had some bone pain (group 2), and 52 (18{\%}) had prominent bone pain that overshadowed other manifestations of the leukemia (group 3). Statistically significant differences were found between the groups for hemoglobin concentration (p<0.001), leukocyte count (p=0.014), absolute neutrophil count (p=0.002), percentage of circulating blast cells (p=0.009), and platelet count (p<0.001). Children in group 3 had values closer to normal for all these values than those of patients in the other groups. Group 3 patients had symptoms an average of more than 2 weeks longer before diagnosis, and had significantly lower serum uric acid and higher calcium levels than patients in the other groups had. No differences were detected among the groups in age at diagnosis, gender, or survival rate. We conclude that children with acute lymphoblastic leukemia who have prominent bone pain preceding the diagnosis frequently have nearly normal hematologic values and that this feature may contribute to a delay in diagnosis.",
author = "Jonsson, {Olafur G.} and Peggy Sartain and Ducore, {Jonathan M.} and Buchanan, {George R.}",
year = "1990",
doi = "10.1016/S0022-3476(05)80535-9",
language = "English (US)",
volume = "117",
pages = "233--237",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "2 PART 1",

}

TY - JOUR

T1 - Bone pain as an initial symptom of childhood acute lymphoblastic leukemia

T2 - Association with nearly normal hematologic indexes

AU - Jonsson, Olafur G.

AU - Sartain, Peggy

AU - Ducore, Jonathan M.

AU - Buchanan, George R.

PY - 1990

Y1 - 1990

N2 - We reviewed the records of all patients with a diagnosis of ALL made at our center during a 13-year period to determine the relationship between bone pain and the hematologic findings at diagnosis of acute lymphoblastic leukemia. Of 296 eligible patients, 179 (60%) had no bone pain (group 1), 65 (22%) had some bone pain (group 2), and 52 (18%) had prominent bone pain that overshadowed other manifestations of the leukemia (group 3). Statistically significant differences were found between the groups for hemoglobin concentration (p<0.001), leukocyte count (p=0.014), absolute neutrophil count (p=0.002), percentage of circulating blast cells (p=0.009), and platelet count (p<0.001). Children in group 3 had values closer to normal for all these values than those of patients in the other groups. Group 3 patients had symptoms an average of more than 2 weeks longer before diagnosis, and had significantly lower serum uric acid and higher calcium levels than patients in the other groups had. No differences were detected among the groups in age at diagnosis, gender, or survival rate. We conclude that children with acute lymphoblastic leukemia who have prominent bone pain preceding the diagnosis frequently have nearly normal hematologic values and that this feature may contribute to a delay in diagnosis.

AB - We reviewed the records of all patients with a diagnosis of ALL made at our center during a 13-year period to determine the relationship between bone pain and the hematologic findings at diagnosis of acute lymphoblastic leukemia. Of 296 eligible patients, 179 (60%) had no bone pain (group 1), 65 (22%) had some bone pain (group 2), and 52 (18%) had prominent bone pain that overshadowed other manifestations of the leukemia (group 3). Statistically significant differences were found between the groups for hemoglobin concentration (p<0.001), leukocyte count (p=0.014), absolute neutrophil count (p=0.002), percentage of circulating blast cells (p=0.009), and platelet count (p<0.001). Children in group 3 had values closer to normal for all these values than those of patients in the other groups. Group 3 patients had symptoms an average of more than 2 weeks longer before diagnosis, and had significantly lower serum uric acid and higher calcium levels than patients in the other groups had. No differences were detected among the groups in age at diagnosis, gender, or survival rate. We conclude that children with acute lymphoblastic leukemia who have prominent bone pain preceding the diagnosis frequently have nearly normal hematologic values and that this feature may contribute to a delay in diagnosis.

UR - http://www.scopus.com/inward/record.url?scp=0025288662&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025288662&partnerID=8YFLogxK

U2 - 10.1016/S0022-3476(05)80535-9

DO - 10.1016/S0022-3476(05)80535-9

M3 - Article

C2 - 2380822

AN - SCOPUS:0025288662

VL - 117

SP - 233

EP - 237

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 2 PART 1

ER -