Kamrun NaharCombined Military Hospital, Bangladesh
Title: Incidence and outcome of childhood acute leukemia in a tertiary care hospital of Bangladesh armed forces
Background: Worldwide cancer is the second leading cause of death in children under 15 years and acute leukemia is the most prevalent cancer among children.
Objective: The objective of the study was to analyze the incidence and overall outcome of childhood leukemia patients aged of 0-12 years in Combined Military Hospital (CMH), Dhaka.
Methodology: It was a retrospective cross-sectional study. Children below 12 years of age with a confirmed diagnosis of Leukemia received treatment from the Paediatric Oncology unit of Department of Paediatric of CMH Dhaka were taken for this study. Data has been collected from hospital-based cancer registry records from 2011 to 2021. Their present status has been collected from regular OPD or by phone calls.
Results: The commonest cancer was found Acute Leukemia (52%), among them Acute Lymphoblastic Leukemia (ALL) 83.15% & Acute Myeloid Leukemia (AML) 16.85%. Morphological (FAB classification) sub-divisions revealed ALL-L2 (31%) was the commonest group for ALL. In case of AML, AML-M3 (APML) was the commonest (27%). Immunophenotyping of cells revealed Pre-B ALL is the most commonest followed by B-ALL, Pre-T ALL, and others. In case of AML, myeloid group of cells was found in all cases. Cytogenetic analysis revealed most children presented without any cytogenetic abnormalities; in case of ALL 68% & in case of AML 50% of patients had no cytogenetic abnormalities.The t(12;21) ETV6-RUNX1 (21%), t(1;19) (q23,p13) E2A/PBX1 (11%) are two most common genetic abnormalities found in ALL and t(15;17) (q22;q12) M3,M3v PML-RARA was the commonest cytogenetic abnormalities & (8;21) (q22;q22) RUNX1/RUNX1T1 for AML. About 91% of patients started receiving treatment. Refusal rate was only 4.5% which is mostly due to considering malignancy as a grave disease, taboo & others. Overall survival was found 51.7% and expired 41.55% of patients. In case of ALL overall survival was 54% and in case of AML 40%. About 10% of patients reported relapses. Death occurs mainly due to advanced disease at diagnosis, disease progress, sepsis, myelosuppression, and others.
Conclusion: Incidence of Acute leukemia was the highest among all childhood cancer. At the end of study, overall survival was 52% of cases, relapses were seen in 10% of cases.
Will be updated soon.