CLINICAL AND HEMATOLOGICAL EVALUATION OF ACUTE LEUKEMIA IN ADEN HOSPITALS, YEMEN

Iman N. Bin Harize and Gamal Abdul Hamid*

ABSTRACT

Background: Acute leukemia (AL) is serious heterogeneous neoplastic haemopoietic disease. Therefore,
parameters are needed to classify this disease into subtypes. The aim of present study is to determine the frequency
of various subtypes of acute leukemia using French-American-British (FAB) criteria in our population, and to
study the clinical and hematological presentations of acute leukemia. Materials and Methods: This is descriptive
study conducted at two Aden governmental hospitals from January 2011 to September 2012. The total number of
subjects were 53 patients that included both adults and children. History and physical examination, complete blood
count, bone marrow aspiration and cytochemistry stains were done for all patients. Results: Fifty three patients
were studied (males= 37, females= 16), with male to female ratio 2.3:1. The age ranged between 18 months to 76
years with a mean age of 22 years. Acute Lymphoblast leukemia (ALL) was 58.5%, acute myeloid leukemia
(AML) 37.7% and undifferentiated leukemia 3.8%. The predominant subtype of ALL was L1 (51.6%) followed by
L2 (45.2%). In AML; M2 (40%) was the predominant subtype followed by M4 (25%) and M5 (20%). All patients
were anemic; their hemoglobin was 3.5 -12 g /dl. The WBC count was quite variable ranged from 0.40 to 300.0
×109/l. Similarly the platelet count was ranged from 6.0 to 250.0×109/l. Cytochemical analysis of leukemia, when
coupled with morphology confirm the diagnosis in (95%) of AML cases and (80%) of ALL cases. In AML,
patient’s death is more significant than ALL (P=0.055), and most of the deaths occurred in older patients with no
statistical significance (P=0.08). In ALL, the age and sex were found to be significant prognostic factors. Other
prognostic factors included WBC count, percentage of cytochemical positive blast cells with no significant in both
type of acute leukemia. Conclusions: The most common type of acute leukemia observed in our study was acute
lymphoblast leukemia (ALL) (58.5%), and in the AML subtype the most common one was myeloblastic leukemia
with maturation (M2) (40%).

Keywords: Acute leukemia; FAB classification; Aden hospitals.