Acute myeloid leukemia among patients at the National Oncology Center in Sana ’ a, Yemen: prevalence, subtypes, and hematological features

Abstract

Background Acute myeloid leukemia (AML) is a malignant disorder of the myeloid cell lineage within the bone marrow (BM). It is caused by chromosomal abnormalities resulting in the accumulation of myeloblasts within the BM and infiltration of peripheral tissues. The aim of this study was to determine the prevalence, subtypes, and hematological features of AML among patients at the National Oncology Center (NOC) in Sana'a. Methods This retrospectively registered study was carried out on 747 patients diagnosed with hematological malignancies (HMs). It included 472 (63.2%) males and 275 (36.8%) females, aged 1 to 75 years. The registered data was collected from the NOC in Sana'a, Yemen, between March 2020 and May 2022. These patients came to the NOC from different hospitals and clinics in Sana’a as well as from other governorates. The patients came to NOC for a better diagnosis and appropriate treatment. The diagnosis of AML was performed by CBC, Giemsa-stained blood/BM films, and immunophenotypic using flow cytometry to confirm, if necessary, the definitive diagnosis. The SPSS-26 program was used to analyze the data. Results Among 747 patients, there were 175 (23.4%) patients diagnosed with AML. It included 98 (56%) males and 77 (44%) females, ages 1 to 75. Acute leukemia (ALL and AML) and chronic leukemia (CML and CLL) were detected in 543 (79.7%) and 138 (20.3%) patients, respectively. The relative frequencies of leukemia were ALL, AML, CML, and CLL, which were detected in 49.30%, 23.43%, 11.65%, and 6.83% of patients, respectively. FAB-M2 was observed in 48.57% of patients, followed by M5 (17.72%), M1 (15.43%), M3 (11.43%), M4 (5.71%), and the less common M0 (0.57%), M7 (0.57%), and M6 (0%). The hematological features in AML patients include decreased Hb, increased WBC, and decreased platelets in 96.6%, 81.7%, and 100% of patients, respectively. There were significant positive correlations between age and Hb (p = 0.009) and WBC (p = 0.002), and between Hb and WBC (p = 0.001). Conclusion Leukemia was the most common type among hematological malignancies (HMs). ALL and AML constitute approximately a half and a quarter of leukemia. AML-M2 was the most common FAB subtype in half of the AML patients.