Myelo-Proliferative Disorders in Children: A Ten-Year Experience of Single Institute in Baghdad, Iraq

Author(s):

Mazin F. Al-Jadiry, Hasanein H. Ghali, Safa A. Faraj* and Salma A. Al-Hadad

Background: The myelodysplastic syndromes (MDS) and myeloproliferative disorders (MPD) are rare in childhood, accounting for about 3% of childhood malignancies. It is helpful to consider these syndromes as part of a continuum with the myelodysplastic syndromes on one end and the myeloproliferative syndromes on the other, with a group of “bridging” syndromes in between.
Aim of the study: To study the epidemiological and clinical features of Myeloproliferative disorders in Children Welfare Teaching Hospital (CWTH), Medical City, Baghdad.
Patients and Methods: A retrospective study was done over 10-year period, between January 1, 2000 and December 31, 2009. Fifty consecutive pediatric patients below the age of 14 years with newly diagnosed MPS treated and followed at the oncology unit of CWTH were studied. A review study was done for these patients, including all available medical records including laboratory data. The diagnosis of MPD was suggested by bone marrow aspirate and/or peripheral blood film. WHO morphological classification was carried out in most of the patients.
Results and Discussion: The analyzed group represents about 3.7% of all leukemias treated in the hospital during the study period. There were 31 patients met the criteria of chronic myeloid leukemia (CML), 15 with Juvenile Myelomonocytic Leukemia (JMM) and 4 with MDS. Male to female ratio of 1.2:1, 1.5:1 for CML & JMML respectively while in MDS all were males. Five (10%) patients refused any sort of treatment, nine patients (18%) were referred to other centers (2 for palliative treatment, 5 to receive treatment from their governorates as recommended by MOH and other two patients went abroad for Bone Marrow Transplant), 17 (34%) patients lost follow up, 15 (30%) patients died and 4 (8%) are alive in remission on treatment. Conclusion: High percentage of accelerated and blastic crisis of CML might reflect delay in diagnosis or aggressive behavior of the disease.