Evaluation of children with macrocytosis: clinical study

Abstract

Introduction: in this study, it is aimed to emphasize the causes and importance of macrocytosis in paediatric practice.

Methods: in the paediatric hematology and oncology clinic, 1752 patients evaluated in 2017, patients with macrocytosis were examined retrospectively with clinical and laboratory findings. Patients with macrocytosis were compared with the frequency of severe hematologic diseases such as acute leukemia and bone marrow failure in patients with normocytic and microcytic mean corpuscular volume.

Results: macrocytosis was detected in 72 out of 1752 patients (4.1%) in the study. Acute lymphoblastic leukemia in 11(15.2%), acute myeloid leukemia in 3(4.1%), Fanconi aplastic anemia in 7(9.7%), Diamond-Blackfan anemia in 2(2.7%), aplastic anemia in 1(1.3%), congenital diseritropoetic anemia in 1(1.3%), deficiency of vitamin B12 in 14(19.4%) were diagnosed. Down syndrome was presented in 33 cases (45.8%). The number of patients with acute leukemia diagnosis was 14(0.8%) in the group in which the mean corpuscular volume was either microcytic or normocytic. The incidence of acute leukemia and bone marrow failure was significantly higher in the group with macrocytosis compared between the two groups.

Conclusion: although vitamin B12 deficiency is considered firstly in patients who have undergone cytopenia and macrocytosis in our country, haematological malignancies, bone marrow failures, myelodysplasia and myeloproliferative diseases should be remembered especially in the individuals with Down syndrome at the same time.