Changes of the Platelet Count and Red Cell Distribution Width during Induction Treatment are Predictors of Induction Failure in Pediatric Acute Lymphoblastic Leukemia

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer
during childhood. The goal of this study is to evaluate the value of different
peripheral blood parameters in the prediction of induction remission in these
patients.
Methods: Our study included 100 children with ALL who were admitted to
Shefa Al-Orman Children's Cancer Hospital between January 2022 and January
2024. Data about complete blood counts (CBC) and bone marrow parameters at
days 0, 8, 19, and 42 of induction chemotherapy were collected and analyzed.
Results: B-ALL cases represented 75% of cases. Ninety-four patients achieved
complete remission (CR) by the end of induction. A significant decrease in both
platelets (PLT) and red cell distribution width (RDW) was found to increase the
likelihood of induction failure (p = 0.03 and 0.05, respectively). The ROC curve
revealed that only PLT had significant discrimination ability between successful
and failed induction, with an AUC of 0.64 (p = 0.03).
Conclusion: We concluded that a decrease in platelet count and RDW was
associated with induction failure. Long-term follow-up is needed to evaluate the
effect of these parameters on disease-free survival and overall survival