Acute lymphoid leukemia in Lebanese children: A retrospective study

Acute lymphoid leukemia (ALL) is the most common malignant disease affecting children, accounting for approximately 25% of all childhood cancers. Hence, the majority of these children are in developing countries. ALL is one of the major public health problems affecting the Lebanese children. Our objective was to investigate the epidemiology, laboratory findings and treatment efficacy in ALL children and extrapolate these results to the guidelines used internationally. This retrospective observational cohort study was performed using routine clinical data of 75 ALL children, with age ranging from 0 to 18 years old, attending three major hospitals in Beirut (Lebanon) over a period of thirteen years. Our results showed that males constituted 54.6% of all ALL patients and that ALL is predominant between ages 3–6 years, and that 85.3% of children were pre B-cell ALL. Furthermore, the results showed that there was an association between ALL type and age. Male patients had the highest numbers of high and low risk patients. Moreover, 48% of ALL patients had a WBC count less than 10,000/μL. An association was found between risk group and initial WBC. Cytogenetic abnormalities were detected in 17% of all patients. 73% of the patients cleared their lymphoblasts by day 15 of induction. Moreover, 63% of patients were free of disease for more than 5 years and 27% had complete remission, while 8% of patients died; of whom one had Down syndrome. This study highlights the situation of ALL in children in Lebanon. It provides a realistic overview that may help establish national guidelines for the investigation and management of childhood ALL.