Abandonment and Outcome of Childhood Acute Myeloid Leukemia in A Tertiary Level Hospital.

ABSTRACT

Acute leukemias are the most common child hood malignancy, of which acute myeloid leukemia (AML) are 15 to 20%. Abandonment is one of the most important causes of treatment failure in AML in developing countries. Lost to follow-up is also a big problem in low income countries. Many patients stop therapy soon after diagnosis due to cost, distance and ignorance. To determine the abandonment, outcome and treatment related mortality (TRM) and morbidity among children with AML. This prospective observational study was conducted in the Department of Pediatric hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February 2013 to January 2014. Fifty (50) patients of AML visited to out patient department (OPD) of Pediatric hematology and Oncology. Among them 11(22%) patients refuse treatment from outdoor. Thirty nine (78%) patients of AML were selected as per inclusion and exclusion criteria. After proper evaluation and clinical examination of these patients, CBC and Bone marrow examination was done for confirmation of diagnosis. A total of 39 patients were recruited in this study. Seventeen (43.6%) patients were male and 22(56.4%) were female. Mean±SD of age was 7.80±4.42 years and range was 1 year to 18 years. Out of 39 patients, 18(46.1%) patients were abandoned, 15(38.4%) expire, relapse 2(5.2%) & alive 4(10.3%). High abandonment (46.1%) and treatment related toxic death (38.4%) has compromised the outcome of acute myeloid leukemia. However AML can be treated with better outcome if improved the supportive care, reduce toxic death, refusal or abandonment.