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Bone pain and its relation to the initial presentation of acute lymphoblastic leukemia

Acute lymphoblastic leukemia is a hematopoietic malignancy characterized by alterations in the growth and proliferation of lymphoblastic cells in bone marrow, with consequent accumulation of immature white blood cells called blasts. It is the most common malignant neoplasm seen in under fifteen-year-olds. Acute lymphoblastic leukemia frequently presents with fever, ecchymosis and paleness, however bone pain is the initial symptom found in 25% of the cases. The objective of this work is to determine the frequency of bone pain and its relation with clinical and laboratory data in children with acute lymphoblastic leukemia admitted in the Pediatric Oncology Unit of Hospital de Base de São José do Rio Preto, São Paulo, Brazil. Fifty children with acute lymphoblastic leukemia, aged under fifteen years old, in the period from December 1991 to December 2001 were assessed. Among the children studied, 18 presented bone pain as the main complain and of these, 14 presented a time of evolution (period between first symptom and diagnosis) of over 15 days (p=0.01). Moreover, 13 children with bone pain and time of evolution greater than 15 days had hemoglobinometry below 8 g/dL (p=0.008).

Acute lymphocytic leukemia; bone pain; hemoglobinometry; time


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