The New Times (Kigali)

12 November 2012

Rwanda: Scientists Call for More Research On Leukemia

African Cancer researchers have been urged to put more emphasis on leukemia to ascertain the prevalence of the disease in the region.

According to Prof. Justin Wane, the Head of Pathology Department at Rwanda Biomedical Centre the prevalence of leukemia is unknown in Rwanda.

"There is need to conduct research in our region because the disease is there and we have to know its magnitude. Unfortunately the burden of leukemia has little known about it," he said.

According to the United States National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, 12,330 Americans were estimated to have been diagnosed with acute myeloid leukaemia (AML) in 2010 and 8950 were expected to die of the disease.

Now what could be the magnitude of the disease in Africa or East Africa?

Wane said although chances of survival exist, in general, acute leukemias have worse prediction than chronic leukemias. Hence the chances of survival are minimal.

"Yes there are survivors but it depends on the type," said the expert.

Leukemia is a chronic disease that develops subsequent to the cruel transformation of one or more normal hematopoietic progenitor cells, acute leukemias are hematologic malignancies with increased numbers of myeloid or lymphoid blasts,

The term "acute," historically referring to a rapid onset and promptly fatal outcome, now indicates the relatively undifferentiated nature of the leukemic cells,

They can be categorised by morphologic findings, genetic abnormalities, putative etiology, cell of origin, immunophenotypic qualities and clinical characteristics.

Leukemias are categorised into 2 groups: acute and chronic leukemias (myeloid/CML and lymphoid/CLL).

"The way to treat varies with the group, the subgroup and types. The forecast varies also with the categorisation," Wane explained

The bad news about the disease is that the available medicines can only induce decrease but do not cure the disease.

The other problem that was highlighted was that patients turn up late for diagnoses making it hard to prolong their lives.

"Yes the diagnosis can be done early and if the treatment is in time the survival of the patient can be prolonged," Prof Wane continued.

Meanwhile, combination of the two types of leukemia is Acute Lymphoblastic Leukemias, (ALL).

ALL are more frequent in children than in adults. AML are more frequent in young adults while Chronic Leukemias (Myeloid and lymphoid) are seen in elderly.

The overall annual incidence of leukemias in the general population is about 4/100,000, with approximately 70% of them being acute myeloid leukemia (AML).

AML accounts for about 15% of childhood leukemias and for approximately 80% to 90% of acute leukemias in adults, with the median age at diagnosis being about 70 years. The age-specific incidence of AML is similar to that of other solid tumors in adults, with an exponential rise after 40.

With regard to ALL, 60% of cases are seen in children, with a peak incidence in the first 5 years of life and a subsequent drop in incidence until age 60, when a second peak emerges, the incidence of both ALL and AML is slightly higher in males than in females.

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