Demographic and pattern of childhood acute leukemia in Duhok, Kurdistan region of Iraq, 2009-2018

Abstract

Background and objectives: Leukemia is a common childhood cancer, constituting more than 25% in many pop- ulations. The most frequent type of childhood leukemia is acute lymphoblastic leukemia. The aim of this study is to describe the annual incidence, rate and demographics of acute childhood leukemia and their patterns in Duhok, Kurdistan - Iraq, in the period from 2009 to 2018. Methods:It is a retrospective study that was conducted at Heevi Pediatric Teaching Hospital in Duhok. A total of 198 patients, who were diagnosed as new cases of acute leukemia and were less than 15 years of age in the past ten years (from 2009 to 2018), were included in this study. Demographic data and the presenting hematological values of acute leukemia, based on cytomorphologic characteristics of bone marrow leukemic blast cells, were studies. Results: Childhood acute leukemia represented about 40 % of the total percentage of cancers among children in Duhok. It was more predominant in boys (53.5%) than in girls (46.5%). The cases peaked at 2-10 years cohort (69.2%). The number of cases ranged from 17 cases in 2009 to 15 cases in 2018 and reached a peak of 31 cases in 2016. The most prevalent type of leukemia was Acute Lymphoblastic Leukemia (ALL) (161 cases, 81.6%), followed by Acute Myeloid Leukemia (37 cases, 18.4%). The overall annual incidence rate was 2.0 cases /100,000 per year. The yearly incidence rates of leukemia were 1.3 – 2.4 cases /100,000. The highest incidence rate was in Duhok center (2.4 cases /100,000) and Zakho (2.3 cases /100,000); however, the least incidence rate was in Amedi (1.3 cases /100,000). The incidence of ALL appears to be nearly fourfold higher than the incidence of Acute Myeloid Leukemia in different areas of Duhok. Conclusions:It was found that childhood acute leukemia had lower prevalence in Duhok, and the clinical hematological features were similar to that of other studies.