Objective: To evaluate the pattern of changes in the platelet indices in different Leukemias. Material and method: This descriptive cross-sectional study was conducted in the Pathology Department of Khyber Teaching Hospital from January 2021 to December 2021 (1-year duration). Diagnosed acute and chronic leukemia cases were included while those receiving therapeutic chemotherapy were excluded. The platelet count was analyzed as a part of complete blood counts by the Sysmex Hematology analyzer in the Hematology section of the Pathology department. The changes observed in the platelet counts in different types of leukemia were recorded in a proforma. Mean, standard deviation, frequency and percentages were used to compute variables. Results: The age range of the 100 included cases of leukemia was 01 - 50 years. The mean age of the study population was 30 ± 10 SD years. Platelet count was low in acute Leukemias and chronic lymphocytic leukemia. Only in chronic myeloid leukemia, raised platelet count was seen (in 62% of cases). Mean platelet volume and platelet distribution width were decreased in all leukemias. Conclusion: Platelet indices are decreased in Leukemias, with the exception of chronic myeloid leukemia where platelet count is raised. Keywords: Platelet count, Acute lymphoid leukemia, Acute myelogenous leukemia, Chronic lymphocytic leukemia, Chronic myelogenous leukemia.  

Background: β-thalassemia is an autosomal recessive hereditary hemoglobin production disorder characterized by abnormal hemoglobin synthesis. The efficient and safe therapies for transfusion-dependent β-thalassemia (TDT) patients are desperately required to minimize the requirement for blood transfusion. Objective: To establish the safety and efficacy of low-dose thalidomide in TDT patients. Methodology: The retrospective cohort study was conducted in Khyber Medical University, Peshawar and Blood Diseases Clinic, Peshawar to investigate the safety and efficacy of low-dose thalidomide therapy in TDT patients. Samples were collected from the diagnosed cases of TDT patients whose ages were ≥3 years and were on thalidomide treatment for a period of ≥6 months. Complete blood count CBC was performed on Sysmex XP-100, Japan and biochemical tests were performed on Cobas 6000 analyzer series. Comprehensive patients’ demographics, clinical history and prognosis data were recorded and analyzed using the SPPS 27. Results: The patient characteristics, biochemical parameters and hematological response were assessed and statistically tested for 384 TDT patients using low-dose thalidomide therapy. Applying the criteria for the Hb level achievement, we marked the significant results (<0.001) for Excellent, Good, and Partial responders that were 184 (47.9%), 96 (25%), and 60 (15.6%), respectively. The common side effects observed with the drug included abdominal discomfort, nausea, vomiting, headache, constipation, dizziness, fatigue, anxiety, repeated infections, and skin rash, that were controlled with symptomatic treatment and/or dose adjustment. Conclusion: Collectively, thalidomide is safe and effective in increasing Hb levels thus reducing the requirements of blood transfusion in TDT patients. Future clinical trials are suggested to strengthen the efficacy and safety of low-dose thalidomide and to establish clinical guidelines for its rational use in TDT patients.

Background: β-thalassemia is a significant public health problem in Pakistan with higher carrier rate and disease frequencies. Its mutation prevalence is highly geographical and ethnicity dependent. Objective: To investigate the prevalence of genetic mutations and demographics in transfusion-dependent β-thalassemia (TDT) patients in Pakistani communities. Methodology: Samples were gathered from TDT patients who had been diagnosed and met the inclusion criteria. The SPPS 27 was applied to analyze comprehensive patient demographics, clinical history, and prognostic data. For detection of genetic mutations in TDT patients’ DNA extraction and polymerase chain reaction (PCR) were applied using the relevant screening protocols. Results: A total of 384 patients of TDT were screened from almost 79 various ethnic castes of Pakistan. The Cd 8-9 (+G) mutation was discovered to have the highest number of mutations followed by IVS 1-5. In demographics, Dera Ghazi Khan led in the disease prevalence, followed by Peshawar, Malakand, and Kohat divisions. The areas that have a remarkably high Excellent and Good (Ex+G) responders were Rawalpindi, Multan, Faisalabad, Gujrat, Sukkur, Shaheed Benazirabad, and Merged Districts (Fata). The areas that have comparatively poor Ex+G responders (≤50%) were Sargodha, Sahiwal, Loralai, Pasheen, and Gilgit-Baltistan. Conclusion: Our findings determined the prevalence of genetic mutations and demographics of TDT patients in the diverse community of Pakistan with significant response to low-dose thalidomide in most of the Pakistani communities. For precision medicine and further ensuring the safety and efficacy of low-dose thalidomide in TDT patients, multicenter and large scale clinical trials with Bayesian approach are recommended.