Childhood Leukaemia: Is it a Problem in Tropical Africa?

This is a report on the frequency and biogical aspects of childhood leukaemia in tropical Africa based on experience from Kenya and the literature. Out of the 934 cases of leukaemia diagnosed, treated and followed up at Kenyatta National Hospital between 1976 and 1985, 347 occurred in children below the age of 15 years and comprised 37% of leukaemia in all ages. Childhood acute leukaemia formed 52.3% of all the acute leukaemias. Acute non-lymphocytic (ANLL) and acute lymphocytic leukaemias (ALL) occurred. in almost equal proportions 42 % and 46 % respectively. FAB ANLL, M4 and FAB, ALL, L1 subtypes predominated although ALL, L2 (45%) was encountered almost as frequently as ALL, L1 (50%). The acute leukaemias had a peak occurrence in the 5-9 age group at a median frequency of 41 74. These observations are generally true for childhood leukaemia patterns in sub-Saharan Africa. T-cell ALL phenotype was the most commonly diagnosed, being 46'x of ALL. Clinically advanced disease, severe malnutrition and common ocular chloromata were notably prominent. Remission induction and survival results were noted to be inferior to those obtained in Western countries and are attributed to the presence of many risk factors and unsatisfactory management facilities.