Hematological Profiling and Assessment of Suspected Environmental Factors of Brain Tumor Patients: A Prospective Study of a Tertiary Care Hospital in Pakistan

Objectives: To assess environmental factors that may influence formation of brain tumors and to evaluate alterations in blood parameters of high grade brain tumor (HGBT) and low grade brain tumor (LGBT) patients. Methods: After WHO classification of brain tumors, CBC parameters were evaluated for all groups, i.e., HGBT patients, LGBT patients and control group (CG). Mean values of CBC (complete blood count) parameters were compared statistically with T test between patients and CG. Results: Most reported tumor grade was glioblastoma. Most of the parameters were found below the normal range for both HGBT and LGBT patients. CBC parameters were altered in majority of HGBT patients as compared to LGBT patients. According to T test, statistically significant differences were observed (p<0.050) in the mean values of following parameters between CG and patients: hemoglobin, white blood cells, hematocrit, red blood cells, lymphocytes, neutrophils, absolute lymphocyte count and absolute neutrophils count. Most affected parameter was lymphocyte which was low both in HGBT and LGBT patients. Conclusion: Environmental factors such as contamination of nitrate by agriculture practices and chlorinated byproducts in drinking water were suspected to be associated with the brain tumor formation. Ionizing radiations were considered another factor of brain tumor incidence among the patients who came from areas where terrestrial radiation activity is found. Hematological abnormalities can occur in brain tumor patients and this study affirms that brain tumor cells may be modulating host immune response. Peripheral blood cells may have genetic markers correlating with brain tumor development.