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Acute myeloid leukemia in children in Pakistan: an audit
S Zaki1, I A Burney, M Khurshid
1Department of Family Medicine, Aga Khan University Hospital, Karachi.
Insights
Pediatric Acute Myeloid Leukemia (AML) in Pakistan shows advanced disease and high early death rates. Outcomes for children with AML were worse than previously reported.
Area of Science:
- Pediatric Hematology
- Oncology
- Leukemia Research
Background:
- Acute Myeloid Leukemia (AML) is a significant pediatric cancer.
- Understanding disease characteristics and treatment outcomes in specific regions is crucial for improving care.
Purpose of the Study:
- To investigate the clinical features and treatment of pediatric Acute Myeloid Leukemia (AML) in Pakistan.
- To assess the outcomes of children diagnosed with AML in a Pakistani setting.
Main Methods:
- Retrospective chart review of pediatric patients (<14 years) diagnosed with AML between 1987 and 1997.
- Data analysis focused on clinical presentation, morphological subtypes, and treatment responses.
Main Results:
- Twenty-three pediatric AML patients were reviewed; M3 subtype was most common (43%).
- High rates of hyperleucocytosis (22%) and elevated LDH (95%) were observed at presentation.
- Early mortality was high (43%), with 73% of evaluable patients achieving remission, and a median survival of 9 months.
Conclusions:
- Pediatric AML patients in Pakistan often present with advanced disease.
- A high early death rate (within 28 days) was noted.
- Long-term outcomes for pediatric AML in this cohort were inferior to published data.
Objective:
To see the clinical features and treatment of children with Acute Myeloid Leukemia (AML) in Pakistan.
Setting:
Tertiary referral at a specialist Hematology/Oncology center.
Methods:
Retrospective, chart-based review of children (less than 14 years) admitted to the hospital with a diagnosis of AML between January 1987 and August 1997.
Results:
A total of 23 patients were admitted. There were 18 males and 5 females. The mean age was 8 +/- 5 years. M3 was the commonest morphological subtype (43%). Twenty-two percent of the patients presented with hyperleucocytosis (TLC > 100 x 10(9)/L) and 95% with an elevated LDH (> 548 IU/L). Pneumonia at presentation was seen in 29%. Of 23 patients 14 were evaluable for responses. Six patients died early (43%); 3 before starting the chemotherapy and 3 during the induction chemotherapy, 8/11 (73%) patients entered remission. The median survival was 9 months.
Conclusion:
The pediatric patients with acute myeloid leukemia present with advanced disease. There is a high early death rate (within 28 days of diagnosis). The long-term outcome was inferior to that reported in the literature.