KESHO CONFERENCE

1. Acute leukaemias among post-paediatric
patients at Kenyatta
National Hospital in 2013-2014.
N.A.OTHIENO-ABINYA, FRCP
DEPARTMENT OF CLINICAL MEDICINE AND
THERAPEUTICS, UNIVERSITY OF NAIROBI.

2. Background:
Acute leukaemias are characterized by abrupt onset,
rapid downward progression and death within
weeks if not effectively treated
. Their proper management is usually demanding, and
requires a dedicated unit with excellent hygiene,
effective antimicrobials, dedicated staff and a
responsive blood donor service capable of delivering
blood and blood products at short notice.

3. Objectives:
In 1991 we published a paper on the poor outcome of
acute leukaemias at KNH.
Two decades later the prevailing conditions by then
don’t seem to have changed significantly.
In an ongoing study on myelodysplastic syndromes
and acute leukaemias among patients aged 13 years
and above, we carried out an interim analysis on
treatment outcomes.

4. Methods:
Details taken included biodata, leukaemia subtypes,
treatment and outcomes.

5. Results:
Total of 55 patients
included.

6. Variable/ Number /Percentage
Gender Number Percentage
Male 36 65.5
Female 19 34.5
Leukaemia type
AML 29 54.7
ALL 26 47.3

7. AGE
Condition Median age Age range
AML 30 13-80
ALL 26 13-56
Note: Ages 0-12 were excluded

8. Outcomes
Condition CR No(%) Death No (%)
AML 1 (3.4) 7(24.1)
ALL 7 (26.9) 9 (27.3)
Note: early deaths in AML, relapses and deaths in ALL

9. Causes of death
Condition Number Percentage
Anaemia 9 60
Neutropenic sepsis 2 13.3
Thrombocytopenic 1 6.7
haemorrhage 1 6.7
Others 4 26.7%

10. Median survival
Condition Median Range
AML 7 1-19
ALL 8 1-29

11. Conclusion:
The outcome for acute leukaemia in 2013/2014 has not
changed from the early 1990s. Lack of blood was
commonest cause of death.
Induction deaths characterized AML while relapses
and deaths were common in ALL.

12. Comments
Anaemia could have been prevented more easily with
a responsive blood donor service.
Common causes of death in acute leukaemia such as
thrombocytopenic bleeding and septic neutropenia
could have emerged in the next stage if anaemia had
been corrected.
All major /teaching hospitals need dedicated
leukaemia services, with paid-up blood donor
services to be considered.

13. SEPSIS
YOUR
ENVIRONMENT/
MY
ENVIRONMENT

16. Acknowledgements
 MD Maina
A Odhiambo
 A Waweru
 J Rajab
 A Kalebi
 P Wanzala