Characteristics of acute leukemia in Chui region of the Kyrgyz Republic
2Kyrgyz-Russian Slavonic University, Bishkek, Republic of Kyrgyzstan
Contact: Dr. Irina A.Tsopova
E-mail: tsopovaira@yandex.ru
Accepted 22 September 2016
Summary
Introduction
It is known about 35 new cases of acute leukemia (AL) being registered per 1 Mio population each year. Incidence of distinct AL types much depends on age and differs for various parts of the world. Purpose of the work was to study demographic parameters, structure and risk factors for AL based on the data of clinical/diagnostic Department of the Kyrgyz Research Center of Hematology (KRCH) considering the population inhabiting Chui Region of the Kyrgyz Republic.
Materials and methods
Complete cross-sectional analysis of data from medical cards of AL patients at KRCH was performed over four years.
Results and discussions
Period of examination: January 2013 – January 2016, the number of people registered with diagnosis of AL was 225 persons. Average age of the patients was 27±9,5 years. Of 225 cases, 136 patients (61%) were 17 to 40 years old (group 1); 62 patients (27%) were 41 to 60 years old (group 2), and 27 patients (12%) (group 3) were older than 60 years. Most of AL patients were male (73%), who significantly prevailed over female patients (р < 0.001), at a gender index of 1.1:1. Average age of male and female patients was, respectively, 33.7±11.1 and 38.2±12.3 years (р < 0,001). The ratio of acute myeloid leukemia (AML) to acute lymphoid leukemia (ALL) was 8:1 in group 3 of patients. Appropriate ratios in groups 1 and 2 were 5:4 and 5:2. As based on the card catalogue, twelve patients refused to receive medical treatment. 92% of the patients received one chemotherapy course, where 8% of patients died during or just after the therapy performed. 88% of these patients received second and third polychemotherapy courses, whereas 11 patients should receive therapy, but refused further treatment. Three patients are out of our access now. When analyzing distribution of the disease onset by months, we revealed increased incidence of AL from November till May, when the highest number of patients was noted (40% of cases being registered from December to February, with 20% in November). Such seasonal distribution showed that the number of patients substantially increased over winter months (р < 0.01). Some factors may represent significant risks for AL (р < 0.01), e.g., agricultural labor with potential exposure to UV irradiation, pesticides, some common factors (car emissions, food additives), smoking (60%), harboring the HTLV viruses (16%), hereditary predisposal for cancer (40%), and 4% could be attributed to stress factors.
Conclusion
Data analysis from medical cards of KRCH registry has shown that, among AL patients, who permanently inhabited Chui Region, 56% of patients were at active working age, and 27% of patients were in their advanced age. The majority of patients (р < 0.01) were males and were elder persons (р < 0,001). More common admission of the patients over the autumn-to-spring time correlates with the main (mostly, environmental) risk factors.
Keywords
Acute leukemia, kyrgyz republic, epidemiology
Accepted 22 September 2016