Rates and trends of childhood acute lymphoblastic leukaemia: an epidemiology study

Abstract

Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer and has a high survival rate when properly managed. prognosis is correlated with many factors such as age, gender, white blood cell (WBC) count, CD10, French-American-British (FAB) classification, and many others. Many of these factors are included in this study as they play a major role in establishing the best treatment protocol. this study aims to demonstrate clinical and laboratory features of childhood ALL in Syria. they were treated at children's University Hospital, the only working major cancer centre in Syria at the time of the study. Data of 203 patients who aged 0-14 years were obtained for this study. Most patients (48.8%) aged (5-9) years with a male predominance (60.9%). The major features for ALL included lymphadenopathy (82.9%), presenting with systemic symptoms (74.9%), TALL subclass (20.2%), L2 FAB classification (36.1%), low educational levels for fathers (53%) and mothers (56.2%), having a high risk (48.4%), and having a duration of symptoms before evaluation for more than 4 weeks (42.6%). Only three (1.5%) patients had normal full blood counts (FBC) and only one (0.5%) patient had an isolated high WBC count at time of presentation. Most patients had either abnormal platelet count (89.3%) or low haemoglobin level (88.8%) when presenting with only (2.0%) having normal levels for both. This suggests that having normal haemoglobin and platelet count can be used for quick screening in crisis time like in Syria for prioritising patients. Many prognostic factors were significantly different from medical literature which emphasises the importance of local studies in the developping countries. this study included a high prevalence of Tall , L2 FAB classification, high-risk and other variables which require further studies to evaluate the aetiology of these features, especially that treatment protocols may have a higher mortality in developing countries when not adjusted to local variables.

Interactions of Consanguinity and Number of Siblings with Childhood Acute Lymphoblastic Leukemia

“…ALL in Syria has distinguished features that may be from the unique environment and exposure to different substances [ 26 , 27 ]. This is the first study to evaluate the effect of consanguinity and number of siblings on different variables of childhood ALL as this is important for more personal treatment to maximise the outcomes, mainly in countries with high prevalence of these phenomena.…”

Breastfeeding and acute lymphoblastic leukaemia: potential leukemogenesis in children in developing countries

“…The potential risk for leukaemia, especially ALL, was negatively correlated with BF in more than one study, mainly in developed countries. This suggests that there might be additional factors in Syria that have contributed to our ndings, especially that ALL in Syria has different patterns than most of the other countries [21], and that Syria has unique factors that can be from war or the unique environment [22]. This leads to several hypotheses which can explain additional underlying factors for our ndings in developing countries.…”

Isolated tuberculosis of the spleen presenting with fever of unknown origin in a vaccinated child

“…This is not the first case to report financial hurdles in Syria that prevented proper diagnosis and management [ 8 ]. Although Children’s University Hospital is considered the best centre for children in Syria, especially for haematological disorders [ 9 ], biopsy from the spleen is avoided in this hospital due to high rates of complications and a lack of experience with this procedure.…”