Background Leukemia represents a significant and rising health burden in India. Despite this, a government-maintained population-based cancer registry is lacking in Jharkhand. This study aimed to characterize the clinico-hematological and immunophenotypic profile of newly diagnosed leukemia cases from a tertiary care center in this underrepresented region. Methods This was a hospital-based, cross-sectional study conducted in the Department of Pathology, Rajendra Institute of Medical Sciences, Ranchi, India, over a two-year period (February 2024 to January 2026). A total of 151 newly diagnosed leukemia cases were evaluated. Peripheral blood smear, bone marrow aspiration, and immunophenotyping by flow cytometry were performed in accordance with the World Health Organization Classification of haematolymphoid tumours, Fifth Edition (WHO-HAEM5) and International Consensus Classification (ICC) criteria. Data were recorded in Microsoft Excel (Redmond, USA) and analyzed using Jamovi v2.7.17. Results Of the 151 patients, the mean age was 36.7 ± 19.8 years, with a male predominance (74.2%; M:F = 2.9:1). The majority of patients were from a rural background (79.5%). Chronic myeloid leukemia, chronic phase (CML-CP) was the most frequent diagnosis (27.8%), followed by acute myeloid leukemia (AML) and B-cell acute lymphoblastic leukemia (B-ALL) (24.5% each), chronic lymphocytic leukemia (CLL) (12.6%), T-cell acute lymphoblastic leukemia (T-ALL) (8.6%), and mixed phenotype acute leukemia (MPAL) (2.0%). Fever and bleeding manifestations were more prevalent in acute leukemias (p < 0.001). Severe thrombocytopenia was almost universal in acute leukemias. CD34-positive AML showed higher WBC counts, higher blast percentages, and lower hemoglobin and platelet counts compared to CD34-negative cases (all p < 0.05). CD10-negative B-ALL showed higher WBC counts (p < 0.001), higher blast percentages (p = 0.008), and lower platelet counts (p = 0.048) compared to CD10-positive cases; these findings should be regarded as exploratory given the small subgroup size (n = 5). Conclusions This study establishes a baseline clinico-hematological and immunophenotypic profile of leukemias in Jharkhand. These findings reflect the need for a state-level population-based cancer registry and strengthened diagnostic infrastructure in the region.
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