ALL-481 Infant Cancer in Armenia: Nationwide Survey for the Period of 1995-2021

Abstract

Cancer among infants is very rare and requires adapted multimodality approaches for diagnosis and treatment. Before 2008, limitations of effective pediatric cancer treatment in Armenia belonging to low and middle income countries (LMIC) resulted high mortality rate in infants. The situation has substantially improved since then. The aim of this study was to evaluate the incidence of different cancer subtypes in children younger than one-year age in Armenia. Retrospective study was conducted among children (age of 0-12 months) with cancer, who were treated and/or diagnosed at Hematology Center after Prof. R. H. Yeolyan, Muratsan Hospital Complex of YSMU and Pediatric Cancer and Blood Disorders Center of Armenia between 1995 and 2021. It should be noted that the third center was established in 2019 as a result of merging all existing pediatric hematology and oncology units in Armenia. Epidemiological, social, medical information was collected through all 971 patients charts review. During the mentioned period of time, 61 children aged less than one year were diagnosed with cancer. Male/female ratio was 1.2. Acute lymphoblastic lymphoma (ALL) was diagnosed in 20 patients (32.78%), neuroblastoma in 14 (22.95%), sacrococcygeal teratoma in 6 (9.84%), Langerhans cell histiocytosis in 5 (8.2%), nephroblastoma in 4 (6.56%), acute myeloid leukemia in 3 (4.92%), Ewing sarcoma in 2 (3.28%), glioma of optic nerve, atypical teratoid/rhabdoid tumor, medulloblastoma, Kaposiform hemangioendothelioma, monocular retinoblastoma, desmoplastic infantile ganglioglioma, rhabdoid tumor of the kidney in 1 case (1.64%). Out of 61 patients, 19 had a fatal outcome; majority (13 patients, 68%) of deaths were reported before 2008. Survival rate of infants diagnosed with cancer after 2008 was reaching 85%. This is the first nationwide report of cancer cases among infants in Armenia. Among infant cancers representing 6.3% (61/971) ALL demonstrated the highest incidence. Multidisciplinary care, availability of essential diagnostic and treatment modalities helped to improve survival rate of infants with cancer after 2008.