Frequency of leukemia types and flowcytometric immunophenotypic characterization of acute lymphoblastic leukemia presenting at the university teaching hospital, Lusaka

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Date
2019
Authors
Zimba, Jonas
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The University of Zambia
Abstract
The Frequency of Leukaemia types vary in different geographical locations and between age groups and gender. The diagnosis of Leukaemia at UTH is done by Morphological examination of blood or bone marrow smears only. Immunophenotyping is a further diagnostic tool that can be performed to diagnose Leukemias and in this study it was used to diagnose and sub type Acute Lymphoblastic Leukaemia (ALL).The aim of the study was to determine the frequency of the Leukaemia types and to characterize ALL at UTH by immunophenotypes and compare these patterns to those occurring in other parts of the world.A cross sectional descriptive study in which 72 consecutive cases of different types of leukemias occurring between June 2014 and June 2015 were analyzed from records and Laboratory results for frequency and epidemiology of Leukaemias Also 14 consecutive cases of ALL occurring between June 2015 and October 2015 were analyzed and characterized by flow cytometry of blood or bone marrow samples at UTH in Lusaka, Zambia. The most frequent Leukaemia was chronic myeloid Leukaemia (CML) at 55.5%, followed by Acute lymphoblastic Leukaemia (ALL) at 15.3%, then 13.9 % for each, Acute Myeloid Leukaemia (AML) and chronic lymphocytic Leukaemia (CLL), and lastly 1.4% for other Leukaemias. The median age of all Leukaemia types was 36 and age range was from 1 to 82 years. Of the total 72, 12(16.7%) were children (< 15 years) and 60 (83.3%) were adults (> 15 years). Of the 72 cases 32 (44.4%) were females and 40 (55.6%) were males (M: F ratio 1.3: 1). The 14 ALL had expressed CD markers and were immunophenotyped as follows; 6 (42.9%) T cell lineage ALL, 6 (42.9%) B cell lineage ALL and 2 (14.2%) were Mixed lineage ALL. B cell lineage was further sub classified as follows; 4 (66.7%) were Common ALL(C ALL) while 2 (33.3%) were Mature B cell ALL. The T cell lineage was also further sub typed as follows 1(16.7%) Precursor T ALL while the Mature T Cell ALL was 5(83.3). Of the 14 ALL cases 8 (57.1%) were children (< 15 years) and 6 (42.9%) were adults (>15 years). Of the 14 ALL cases 3 (21.4%) were females and 11 (78.6%) were males with an overall M: F ratio of 2.5:1. The study showed that Leukaemias were more common in males than in females and occurred more between 20 to 44 years of age with a peak of 30 to 39 years. ALL was more commonly observed in children whereas both CML and CLL were mostly observed in adults. Further CML was the most common Leukaemia type at UTH. C ALL was the most common B cell lineage ALL while Mature T cell ALL was the most common T cell lineage ALL Flow Cytometric immunophenotyping is an added sensitive diagnostic tool to morphological diagnosis of Acute Lymphoblastic Leukaemia as it not only confirms but also subtypes the ALL. . Key words: Leukaemia, Acute Lymphoblastic Leukaemia, Chronic Myeloid Leukaemia, B cell and T cell
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Keywords
Diseases. , Leukaemia. , Leukemia--classification.
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