Treatment Outcomes and Associated Factors of Acute Lymphoblastic Leukaemia in Paediatrics at Selected Oncologic Centres in Ethiopia: A Multi-Center Retrospective Cohort Study, 2024

Abstract

Background: Acute Lymphoblastic Leukaemia is the most commonly diagnosed childhood cancer worldwide; counting 75% of paediatric leukaemia. In high-income countries, the 5-year survival is above 90%, but survival in low-and middle-income countries is lower scoring less than 45%. Objective: Treatment Outcomes and Associated Factors of Acute Lymphoblastic Leukaemia in Paediatrics at Selected Oncologic Centres in Ethiopia: Methods: A multicentre hospital-based retrospective cohort study was conducted at selected oncologic centres of Ethiopia, 2024. All paediatric patients with ALL who followed from 1st August 2020 to August 2024 were eligible to participate in the study. The pertinent data were collected by using a data abstraction format from the patient‘s medical records and Paediatric Cancer Registry. The extracted data were entered and analysed using the STATA version14. Categorical patient characteristics were summarized using descriptive statistics, and continuous variables were reported using mean and standard deviation. The survival outcomes and its associated factors were evaluated using the Kaplan–Meier analysis and Cox regression analyses, respectively Results: Data of 245 patients, including 119 males (48.6%) and 126 females (51.4%) were analysed. The mean age at diagnosis was 7.925 + 0.29 years (ranging from 1 to 17 years). Majority 67.3% of participants were achieved complete remission during follow up period. Among 245 patients 43 (17.6%) of the participants had relapses and 37 (15.1%) patients died during follow up period. After a median follow-up of 6.67+ 11.24 months, 5-year OS rate and EFS were 43.4% and 10.42 respectively. WBC count at the time of presentation, age, and CNS involvement had a statistically significant influence on overall survival (OS) and Event Free survival (EFS). Conclusion: This study suggested that the persistent challenges of high WBC count, high treatment discontinuation rates, CNS Involvement and the occurrence of very early relapses in our setting, which significantly impacted the OS and EFS of children diagnosed with ALL