Hematological Profiles and Prognostic Markers in Pediatric Hematologic Malignancies: A Narrative Review

Abstract

Pediatric hematologic malignancies, including acute leukemias and lymphomas, represent the most common cancers in childhood and are associated with variable clinical outcomes despite major therapeutic advances. Hematological profiles derived from peripheral blood and bone marrow assessments remain central to diagnosis, risk stratification, treatment monitoring, and prognostication. This narrative review aimed to synthesize existing evidence on baseline and dynamic hematological parameters and their prognostic relevance in pediatric hematologic malignancies. A narrative literature review was conducted using peer-reviewed articles published in English, identified through major biomedical databases, including PubMed, Scopus, and Web of Science. Relevant studies focusing on pediatric populations with acute lymphoblastic leukemia, acute myeloid leukemia, and lymphomas were reviewed. Emphasis was placed on conventional hematological parameters, blast characteristics, cytogenetic and molecular markers, and treatment-related hematologic responses. Findings indicate that abnormalities in hemoglobin concentration, leukocyte and platelet counts, blast morphology, and marrow cellularity reflect disease burden and marrow failure, while cytogenetic and molecular alterations, particularly minimal residual disease status, are among the strongest predictors of outcome. Emerging hematology-based indices may further enhance prognostic assessment, especially in resource-limited settings. Integrating hematological profiles with advanced prognostic markers supports risk-adapted therapy and remains fundamental to improving survival and long-term outcomes in children with hematologic malignancies.