Clinical profile and treatment outcome of Acute leukemia patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

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Addis Abeba University


Background The incidence of acute leukemia is increasing worldwide. In Ethiopia, in terms of incidence among all cancer cases, it ranks fourth and fifth in men and women respectively. Despite acute leukemia being this prevalent nationally and even a more concerning issue in Tikur Anbessa Specialized Hospital(TASH) the largest hemato-oncology center in the country, there have been only few studies done on this area so far. This study is important to have a contemporary data on the clinical presentation and outcome of acute leukemia patients and helps to put a light on gaps of acute leukemia care in for further detailed studies. Objective The Main objective of this study is to define clinical profile and treatment outcome of all patients above the age of 12 years and admitted with the diagnosis of acute leukemia at TASH from January 1, 2015 to December 31, 2017. Methods The study design is a retrospective cross sectional study which was conducted at TASH from June, 2018 to October, 2019. Structured questionnaire was use to collect data from medical record chart of patients diagnosed with Acute leukemia TASH from January 1, 2015 to December 31, 2017. Descriptive analysis and frequencies were done using the software IBM SPSS statistics data editor version 25 .0. Result There were a total of 235 patients above the age of 12 and diagnosed with acute leukemia and admitted to TASH from January 1, 2015 to December 31, 2017. Out of these patients, 59.1% had AML, 40% had ALL and 1 patient had a Bi-lineage leukemia and 1 other had unclassified leukemia. Males were dominant with M: F ratio of 1.58. Majority of patients were young in the age category between 12-30 years. The commonest FAB subtype of AML and ALL were M4 and L2 subtypes respectively. The commonest presenting symptom was symptoms of anemia (94%) and the commonest sign was pallor (89.4%). The commonest laboratory finding was anemia (96.2%) followed by thrombocytopenia (94.9%). Majority (64.6%) of patients had leukocytosis. About 53.6% of patients were started on chemotherapy. Among these, 79.3% took intensive induction regimens while 12.7% patients took palliative treatment only. The commonest induction protocol used for ALL was CALGB, for Non M3 AML was 7+3 and ATRA+ Chemotherapy for patients with AML M3. Patients with AML had CR rates of 63.3% whereas ALL patients had CR rates of 92.9%. Default rates was 10.9% and induction death rate was 28.2% which w has high. The most common cause of death was neutropenic sepsis followed by intracranial hemorrhage. The rate of lost from follow up was very high with only 6 patients currently alive and on follow up. Conclusion The clinical presentation of patients with acute leukemia generally similar with most findings in the literature. However, acute leukemia occurred at a very young age compared with other studies. There is a very high early and induction mortality but comparable CR rates to most centers.



Leukemia, patients