Childhood acute lymphoblastic leukaemia (ALL) in Ghanaians and Germans--a comparative study

The records of 20 ALL patients aged 12 years and below seen at Korle-Bu Teaching Hospital(KBTH) between December 1982 and May 1990 were examined as well as that of their counterparts in Hamburg University Children's Hospital(HHOG) matched by age, sex and as closely as possible date of presentation. Data on clinical and laboratory findings, treatment and outcomes were taken and analysed using binomial proportions and paired samples T-tests. It was found that KBTH patients presented with lower haemoglobin levels, bigger organ enlargements, received less intensive treatment and defaulted more often than HHOG patients. White blood cell(WBC) counts were statistically the same. Achievability of remission was 75% and 100% for KBTH and HHOG patients respectively. Average follow up was 6 months for KBTH patients and 69 months for HHOG. 60% of KBTH patients had defaulted at the time of the study. 75% of HHOG patients were alive at the time of study with the longest follow up being 114 months. It is concluded that in spite of the bigger organ enlargement for the KBTH patients, WBC count which is the single most important prognostic factor was the same for both groups, and with less intensive therapy, achievability of remission for KBTH was 75%--reasonably good. More work need to be done in Africa on prognostic features and treatment.