Chromosomal Abnormalities In Childhood Acute Leukaemia At Kenyatta National Hospital, Nairobi

Abstract

This is a prospective study of 14 patients aged from ten months to 13 years admitted to KNH with acute leukaemia (AL). Chromosomal analysis was successfully performed in nine children. The clinical and laboratory features of the patients were also analysed in relation to cytogenetic abnormalities identified. The study revealed that eight out of 14 (57!1~) of the patients had acute non-lymphocytic leukaemia (ANLL) and 43% had acute lymphoblastic leukaemia (ALL). Out of the five children with ANLL who had chromosomal analysis performed three (60%) had karyotype abnormal it i es: two pat i en ts had hyperdiploidy, one with AML M5a had 47 chromosomes, and the other with AML M2 had trisomy 21; the third patient had monosomy 7. None of the four patients with ALL who had chromosomal analysis performed had any karyotype abnormalities. Four out of the nine patients, whose karyotypes were determined, died. All the four had normal karyotypes . Two died of haemorrhage having had platelet counts less than 20 x 109/1 which is a poor prognostic feature. The other two died of overwhelming infections. Surface marker studies done during the course of the study were helpful in making a final complemented the morphological diagnosis. diagnosis and

Evidence from the study shows that karyotypic abnormalities in ANLL occur as frequently as those found in other studies. The prognostic significance of the chromosomal abnormalities has not been clearly demonstrated in this study in view of the sample size. It is therefore recommended that further similar but larger studies be performed. A larger study should also bring out any associations between certain karyotypes and morphologi cal types of acute leukaemia.