Abstract
Background: Leukemia accounts for 3–4% of the global cancer burden and represents a significant cause of haematological morbidity in Pakistan. Accurate subtype identification is essential for appropriate treatment yet comprehensive diagnostic data from Lahore's tertiary hospitals remain scarce.
Methods: A descriptive cross-sectional study was conducted in selected tertiary care teaching hospitals in Lahore over six months. One hundred and thirty-nine confirmed leukemia patients (all ages, both sexes) were enrolled by non-probability purposive sampling. Peripheral blood smears (PBS) and bone marrow aspiration (BMA) were performed for each patient.
Results: AML was the most frequent subtype (34.5%), followed by ALL (31.7%), CML (22.3%), and CLL (11.5%). A male predominance was observed (M:F = 1.57:1). Age-subtype association was highly significant (χ² = 84.604, p < 0.001): ALL predominated in children/adolescents; AML and CML in working-age adults; CLL exclusively in adults ≥ 46 years. Peripheral smear sensitivity was 89.6% for AML, 88.6% for ALL, 90.3% for CML, and 62.5% for CLL. Overall diagnostic concordance between PBS and BMA was 86.3% (Cohen's κ = 0.816).
Conclusion: Peripheral blood smear is a rapid, low-cost, and highly informative first-line test that, when read by trained morphologists, achieves near-excellent agreement with bone marrow diagnosis for AML, ALL, and CML.