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3135002 
Journal Article 
Immature Reticulocyte Fraction And Absolute Neutrophil Count As Predictor Of Hemopoietic Recovery In Patients Of Acute Lymphoblastic Leukemia On Remission Induction Chemotherapy 
Rauf, SE; Khan, SA; Ali, N; Afridi, NK; Haroon, M; Arslan, A 
2015 
English 
26377739 
BACKGROUND: Acute lymphoblastic leukemia (ALL) encompasses a group of lymphoid neoplasms that are more common in children and arise from B and T-lineage lymphoid precursor cells. Immature reticulocyte fraction (IRF), a new routine parameter in the hematology analyzer can give the indication of hemopoietic recovery like absolute neutrophil count (ANC).

OBJECTIVE: To evaluate IRF and ANC recovery in patients of ALL on remission induction chemotherapy.

STUDY DESIGN: Descriptive Patient and Methods: 2.5 to 3 ml EDTA blood of 45 ALL patients undergoing remission induction phase of their treatment were sampled and analyzed on Sysmex XE-5000 on day 1 and then after every 2nd day till day of recovery. Absolute neutrophil count more than >0.5 x 109/L on the day corresponding to the first of the three consecutive counts was considered as day of ANC recovery. Immature reticulocyte fraction recovery was percentage of immature reticulocyte fraction in excess of 5%.

RESULTS: Mean age of the patients was 12.04±5.30 years. Distribution of patients by gender shows 25 patients (55.6%) were males and 20 patients (44.4%) were female. On day 1 of induction remission, mean IRF was 13.20±4.92 while mean ANC was 0.36±0.35. Mean recovery day for IRF was 11.89±7.42 and mean recovery day for ANC 17.60±8.96 (p value= 0.0014 with 95% confidence interval). However by day 28, out of 45 patients 36 (80%) showed ANC recovery while 41 (91%) had shown IRF recovery. The remaining patients who had not shown recovery by day 28 were followed up and all of them showed recovery by both parameters till day 39.

CONCLUSION: This study concluded that the post induction bone marrow hemopoietic recovery was earlier by IRF than ANC in children with acute lymphoblastic leukemia on chemotherapy.