Acute lymphoblastic leukemia has a wide variety of presentations. There is paucity of any data addressing pancytopenia at presentation in acute lymphoblastic leukemia. In this study we assessed 84 patients with pancytopenia at presentation. They had a significantly lower incidence of bulky disease at presentation. A significantly higher fraction of these patients (n=66, 78.57%) opted for therapy (P=0.005) as compared with the rest. The estimated mean survival in patients presenting with pancytopenia (67.2+/-17.2 mo) was significantly higher (P=0.031, log-rank test) as compared with that of other patients (47.2+/-7.4 mo). Pancytopenia was an independent predictor of better survival (P=0.043) in multivariate analysis.
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