Childhood Acute Lymphoblastic Leukemia A Clinico - Epidimiological Study

Abstract

Acute lymphoblastic leukemia (ALL) is the most common malignancy in children, representing nearly 1/3 of all pediatric cancers. Annual incidence of ALL is about 30 cases per million people, with a peak incidence in patients aged 2-5 years. Although a small percentage of cases are associated with inherited genetic syndromes, the cause of ALL remains largely unknown. Many environmental factors (e.g., exposure to ionizing radiation and electromagnetic fields, parental use of alcohol and tobacco) investigated as potential risk factors, but none definitively shown to cause lymphoblastic leukemia. Improvements in diagnosis and treatment have produced cure rates that now exceed 70%.Aim of the study: Determine the prevalence of childhood Acute lymphoblastic leukemia (ALL), clinical presentation, mode of treatment, response to treatment and outcome.Patient and method: A Retrospective study was performed in the Pediatric ward in Al- Kadhiymia Teaching Hospital, medical records of children aged 4month-15years, who were diagnosed as ALL between 1st /January/2000 till 1st /Jul/2007 were studied, 32 cases was collected, history and physical finding were taken from the medical records as well as investigations including CBP ,bone marrow aspiration, LFT, RFT, uric acid, cerebrospinal fluid exam., chest X-ray.Chemotherapy was given according to the MRC-97 modified 99 groups B protocol . Results: The majority of the patients were from Baghdad 21 cases (65.63%). Peak incidence was in 2001, 7 cases (21.87%). The majority of the patients were between 1- 5 years 13 cases, (40.63%). Males had affected more than females, male to female ratio equal to 1.13:1 Concerning the clinical presentation, pallor 24 cases (75%) was the main symptom, while hepatosplenomegaly 30 cases (93.75%) and lymphadenopathy 31 cases (96.88%) were the main signs. According to FAB classification, the majority of the cases were histological type L2, 13 cases (40.63%) . The Remission rate was 28 cases (87.5%). Follow - up for 5 years showed that disease free >5 years is encountered in 23 cases (71.87 %).