Clinical, biological, therapeutic and evolutionary characteristics of acute leukemia in the Central African Republic

Abstract

Introduction: acute leukaemias still remain undocumented in Central African Republic.
Objective: To describe the clinical, biological, therapeutic and evolutionary characteristics of Central African patients with acute leukemia.
Materials and methods: It was a descriptive study with duration of 5 years, conducted in Bangui. The diagnosis of leukemia was required a number of blastosis ≥ 20%. Our sample consisted of 27 patients. The epidemiological, clinical, biological and therapeutic parameters were studied.
Results: The mean age of the patients was 29.1 years with the extremes of 3 and 75 years. The sex predominance was male, a sex ratio of 1.7. 62.9% of patients lived in rural areas and were farmers (29.6%), traders (22.2%). The risk factors were exposure to pesticides (22.2%) and benzenes (25.9%). The clinical picture was dominated by deterioration in general condition (85.2%), signs of bone marrow failure (100%), tumor syndrome (51.2%). Biologically, anemia and thrombocytopenia were constant. The cytologic types according to FAB were LAL1 (29.6%), LAL2 (14.8%), LAL3 (7.4%), LAM1 (18.5%), LAM2 (3.7%), LAM3 (7 %). The treatment protocols combining Oncovin-Prednisone and Oncovin Prednisone-Cytarabine according to the type of leukemia were used with 18.5% partial response, no complete remission, 59.2% death, 37% loss to follow-up. The probability of survival at 1 month is 59%, 43% at 2 months and it is zero at 3 months.
Conclusion: Acute leukemia remains a serious and potentially fatal condition in the Central African Republic. Support remains a challenge and requires the improvement of our technical platforms.