Acute leukaemias in adults Ethiopians in a Teaching Hospital

ABSTRACT

Eighty-two consective cases of acute leukaemias in adult Ethiopians were admitted to Tikur Anbessa (Black Lion) Hospital; a teaching and referral hospital in Addis Ababa; Ethiopia; from January 1982 to December 1992. These cases were studied to describe the clinical and haematological findings; response to therapy and prognosis. The age range was 13-78 (mean 29.6) years. The male to female ratio was 1.61. Acute myeloblastic (AML) and acute lymphoblastic (ALL) leukaemias occurred in 53.7 percent and 46.3 percent; respectively. The commonest symptoms were anaemia; fever and bleeding tendencies. The commonest signs were pallor; fever; sternal tenderness and purpura. Splenomegaly was more commonly seen in ALL patients. The haematological findings were anaemia (mean Hgb 6.35 percent); leucocytosis (mean WBC count 88;507/mm3) and thrombocytopenia (mean platelet count 31;700/mm3). Of the patients eligible for evaluation treated with chemotherapeutic agents; only 38.4 percent of ALL and 6.2 percent of AML achieved complete remission. Twenty-seven patients with ALL died from one day to 84 (median 1.0) months after diagnosis. Ten are lost to follow-up from two weeks to 36 (median 2.5) months; one is still alive 40 months after diagnosis. Thirty-nine of the AML patients died from one day to nine (median 0.3) months after diagnosis. Five are lost to follow-up from two weeks to two and a half (median 2.0) months. The causes of death were sepsis and bleeding; separately or in combination. Increasing numbers of acute leukaemia patients are being referred to this centre. Therefore; attempts should be made to equip it for the treatment of such cases