Clinical profile and treatment outcome of Acute leukemia patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
No Thumbnail Available
Date
2019-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
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.
Description
Keywords
Leukemia, patients