Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Pediatrics Oncology

Background: Cure rates in pediatric acute myeloid leukaemia in low- income countries lag behind those in high-income countries, in part secondary to higher rates of treatment related mortality. Patterns of treatment-related mortality are likely to differ between low and high- income countries. Understanding low-income setting patterns is necessary before effective interventions aimed at decreasing treatment-related mortality can be designed.Patients and methods: A protrospective study included the newly diagnosed AML patients aged less than 18 years receiving risk adaptive modified GOC protocol for treatment of AML, at national cancer institute, Cairo University, Egypt in the period from January 2014 and December 2016 then all patient were followed up till Jun 2017.All clinical and laboratories data were analyzed and evaluated. Results: Among 105 patients, the age ranged between 50 days and 17 years with mean of 8.6±5.3years. The studied group was consisting of 58.1% males and 41.9% females with male to female ratio (1.39:1). The follow up period ranged from 0.9 to 39.6 months with median 6.25 months, the overall survival was 45.1% at one year and 36.9% at two year, while the Event free survival of the whole group (EFS) at one year was 39 % and at two year was 33.6% (ranged from 0 to 38.5 months) with median 5.2 months. The mortality rate was 61.8% representing 34/55 of patients who entered induction II, Infection Related Mortalities (IRM) was 76.2% (80/109 patients) while Relapse Related Mortality (RRM) was 3.8% (4/109 patients died after relapse), Disease Related Mortality (DRM) was 3.8% (4/109 patients inform of hemorrhage and hyperleukostasis) for whole group, 21/55 patients were alive till the end of the study (38.2%)

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