Treatment outcomes and prognostic factors in children diagnosed with acute myeloid leukaemia in Uganda

Richard Nyeko ^1,2, Mariana Kruger ^3,4, Nixon Niyonzima ⁵

¹Department of Paediatrics and Child Health, Faculty of Medicine, Lira University, P.O. Box 1035, Lira, Uganda. rnyeko2@gmail.com.
²Department of Paediatrics, University of Antwerp, Antwerp, Belgium. rnyeko2@gmail.com.
³Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁴School of Psychology, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
⁵Directorate of Research and Training, Uganda Cancer Institute, P.O. Box 3935, Kampala, Uganda.
⁶Department of Paediatrics, Mbarara University of Science and Technology, Mbarara, Uganda.
⁷Department of Paediatric Haematology-Oncology, Mulago National Specialized Hospital, Kampala, Uganda.
⁸Division of Paediatric Oncology, Uganda Cancer Institute, P.O. Box 3935, Kampala, Uganda.
⁹Department of Paediatrics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
¹⁰Department of Paediatric Haemato-Oncology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.

⁰Department of Paediatrics and Child Health, Faculty of Medicine, Lira University, P.O. Box 1035, Lira, Uganda. rnyeko2@gmail.com.

Bmc Cancer +

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December 19, 2025

View abstract on PubMed

Summary

Treatment for paediatric acute myeloid leukaemia (AML) in Uganda showed low survival rates due to resource constraints. Improving supportive care and adapting treatment protocols are crucial for better outcomes in low-resource settings.

Area Of Science

Paediatric Oncology
Hematology
Global Health

Background

Paediatric acute myeloid leukaemia (AML) treatment is challenging in low- and middle-income countries (LMICs) due to resource limitations, leading to poorer outcomes.
This study focuses on evaluating treatment outcomes and survival determinants in paediatric AML patients within Uganda.

Purpose Of The Study

To assess treatment outcomes for paediatric AML in Uganda.
To identify factors influencing survival in this patient population.

Main Methods

A retrospective cohort study was conducted, reviewing data from children with AML treated between January 2016 and December 2022 at three Ugandan centres.
Standard induction and consolidation chemotherapy regimens were used, with adaptations for acute promyelocytic leukaemia.
Supportive care was provided to all patients, and data were analyzed using SPSS Version 20.

Main Results

159 children with AML were included; 54.4% achieved complete remission overall, while 31.4% experienced treatment-related mortality.
One-, three-, and five-year overall survival (OS) rates were 39.0%, 25.1%, and 16.7%, respectively. Event-free survival (EFS) rates were similar.
Poor nutritional status, delayed neutrophil recovery, failure to achieve initial complete remission, and incomplete treatment were significantly associated with poor OS.

Conclusions

Survival rates for paediatric AML in this Ugandan study were low, highlighting significant challenges in a resource-limited setting.
Clinical and biological prognostic factors critically impacted survival outcomes.
Enhancing supportive care and implementing resource-adapted treatment protocols are essential for improving outcomes.

Keywords:

Acute myeloid leukaemia Africa Paediatric Prognostic factors Resource-limited setting Treatment outcomes Uganda