We present the incidence and the immunologic characteristics of acute lymphoblastic leukemia (ALL) subsets in Moroccan children. We studied 279 unselected patients below the age of 18 years with newly diagnosed ALL. Cases were classified according to immunophenotype: 216 (77.42%) precursor B-cell phenotype (pB-cell), mature B-cell in 4 (1.43%), and T-cell in 59 (21.15%) cases. The subclassification using the CD10 antibody revealed 197 cases pB-ALL CD10+ (91.2%) and 9 cases T-ALL CD10+ (19.2%). The age distribution showed a peak in incidence between 3 and 5 years among the pB-cell ALLs subtype. There was a significantly higher frequency of males in the T-ALL subset (M/F ratio: 2.93 : 1) and more females in the T-ALL CD10+ subset when compared with the T-ALL CD10– subset. All tested pB-cell-lineage ALLs expressed CD19, CD79a, and surface CD22, terminal deoxynucleotidyl transferase (TdT) was detectable in 89.9% of cases, and cells in 74.1% of cases express
CD34. All tested T-lineage ALL cells have surface CD7 and cytoplasmic CD3 (cCD3) antigens, CD5 was found in 98.2% cases, and 70.5% express TdT. CD1a, surface CD3 (sCD3), and CD4 are detected in more than 80% of cases; this frequency is higher than the 45% generally observed. Myeloid antigens occur more frequently and were expressed in 124 (57.4%) of pB-cell-ALL cases and 20 (33.9%) of T-cell ALL cases. Our results show that the distribution of ALLs in Moroccan children is similar with the general distribution pattern in developed countries except for the high frequency of T-ALL phenotype. The phenotypic profiles of our patients are close to those reported in literature for B-lineage ALLs; for the T-cell ALL subgroup, the blast cells express more CD1a, surface CD3, and CD4 while expressing less TdT. The high frequency of CD1a expression resulted in an excess of the common thymocyte subtype.
Epidemiology and clinical features of RMS in Moroccan children does not differ from others countries. However, EFS is lower than that reported elsewhere due to occasional lack of availability of drugs, inadequate local control, and abandonment.
Good outcomes for pediatric HL patients can be achieved in LMIC using a multidisciplinary team approach, uniform protocol-based therapy, twinning partnership among oncology units in-country and abroad, and a data collection system to monitor compliance and identify gaps in care.
Unlike the other hemoglobinopathies, few researches have been published concerning α-thalassemia in Morocco. The epidemiological features and the mutation spectrum of this disease are still unknown. This regional newborn screening is the first to study α-thalassemia in the north of Morocco. During the period from January 2015 to December 2016, 1658 newborns umbilical blood samples were investigated. Suspected newborns were screened for α-globin defects using Gap-PCR and Multiplex Ligation-dependent Probe Amplification technique. The prevalence of α-thalassemia, its mutation spectrum, and its allelic frequencies were described for the first time in Morocco. Six different α-globin genetic disorders were detected in 16 neonates. This screening valued the prevalence of α-thalassemia in the studied population at 0.96% and showed the wide mutation spectrum and the heterogeneous geographical distribution of the disease. A high rate of carriers was observed in Laouamra, a rural commune in Larache province. Heterogeneity of α-globin alleles in Morocco explains the high variability of α-thalassemia severity. This diversity reflects the anthropological history of the country. These results would contribute to the prevention of thalassemia in Morocco directing the design of a nationwide screening strategy and awareness campaign.
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