Survival Status and Predictors of Mortality Among Acute Leukemia Patients Attending Adult Hematology Oncology Ward at Tikur Anbessa Specialized Hospital, Addis Abeba,Ethiopia,2019.
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Date
2019-06
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Addis Ababa University
Abstract
Background: Leukemia ranked tenth for cancer incidence and ninth for cancer deaths in the world. More than 78% of leukemia occurred in developing country and only 22% in developed countries. However, there is limited information that shows survival status and factors associated with death of adult acute leukemia patients in Ethiopia.
Objectives: the aim of this study was to determine survival status and determinant factors of acute Leukemia at Tikur Anbessa specialized hospital March to April 2019.
Methods: A five year retrospective cohort study was conducted involving all patients seen from January 2014 to December 2018. Patient’s charts were reviewed between Marchs to April 2019. The data was analyzed using SPSS version 25.0. Kaplan–Meier Log-rank model was used to estimate the survival time of acute leukemia patients based on explanatory variables. Bivariate and multivariate Cox proportional hazards regression models was performed to identify the independent factors for mortality.
Result: Overall survival probability of acute leukemia was 0.21 and the median survival was 35 months with median follow-up of 17 months. Acute leukemia subtypes (HR: 4.9, 95% CI: 2.3-10.4,P value <0.00),history of relapse (HR: 3.9, 95% CI: 1.0-7.9, P< 0.002), age (HR:1.25,95% CI: 1-1.75,p<0.01),Hepatomegaly(HR:2.7, 95% CI: 1.36-5.36 , p<0.004) and splenomegaly (HR:2.29 95% CI: 11.2-4.4 ,p<0.014were determinant factors of the acute leukemia mortality.
Conclusion: Survival rate of acute leukemia patients in this study was very low as compared to other studies conducted in the developing as well as developed world. Advanced age, history of relapse, hepatomegaly, splenomegaly and leukemia subtype are determinant factors for acute leukemia. Strengthening cancer care centers, improving community awareness, timely diagnosis and treatment may be necessary to increase patient survival.
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Acute Leukemia, Associated Factors, Survival Status; Tikur Anbessa