Acute lymphoid and myeloid leukemia in a Brazilian Amazon population: Epidemiology and predictors of comorbidity and deaths

Autor: Vanderson de Souza Sampaio, Andréa Monteiro Tarragô, Lilyane Amorim Xabregas, Allyson Guimarães Costa, Alexander Leonardo Silva-Junior, Adriana Malheiro, Fabíola Silva Alves, Marlon Wendell Athaydes Kerr, Nelson Abrahim Fraiji, Maria Perpétuo Socorro Sampaio Carvalho, Fábio Magalhães Gama, Maria Gabriela de Almeida Rodrigues, Alexandre Santos Torres
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Economics
Epidemiology
Social Sciences
Comorbidity
Geographical locations
Hematologic Cancers and Related Disorders
0302 clinical medicine
Medicine and Health Sciences
Salaries
Medicine
Family history
Child
Acute leukemia
education.field_of_study
Multidisciplinary
Incidence (epidemiology)
Myeloid leukemia
Hematology
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Myeloid Leukemia
Leukemia
Leukemia
Myeloid
Acute
Oncology
030220 oncology & carcinogenesis
Child
Preschool
Female
Brazil
Research Article
Acute Myeloid Leukemia
medicine.medical_specialty
Adolescent
Science
Population
Ethnic Epidemiology
03 medical and health sciences
Diagnostic Medicine
Internal medicine
Leukemias
Cancer Detection and Diagnosis
Humans
Cities
education
Aged
business.industry
Infant
Newborn
Infant
Cancers and Neoplasms
South America
medicine.disease
030104 developmental biology
Logistic Models
Age Groups
Labor Economics
Multivariate Analysis
Minimum Wage
Population Groupings
People and places
business
Zdroj: PLoS ONE
PLoS ONE, Vol 14, Iss 8, p e0221518 (2019)
ISSN: 1932-6203
Popis: IntroductionLeukemia is the most common cancer in children and has the highest rates of incidence in industrialized countries, followed by developing countries. This epidemiologic profile can mainly be attributed to the availability of diagnostic resources. In Brazil, leukemia diagnosis is a challenge due to financial viability, lack of hemovigilance services in isolated regions and the vast size of the territory. Its incidence in the state of Amazonas has been increasing since 2010. Therefore, this study aims to describe the epidemiological pattern and spatial distribution of patients with acute lymphoid leukemia and acute myeloid leukemia in Amazonas and identify the predictors of comorbidity and death.Materials and methodsA retrospective cross-sectional study was carried out based on patients' data which was obtained from the database of a referral center for the period of 2005 to 2015. Variables included age, gender, ethnicity, civil status, schooling, income, location of residence, subtype of leukemia, comorbidities, and date of death. The spatial distribution was performed using QGIS v.2.18. Stata software was used for univariable and multivariable logistic regression to evaluate the association between both comorbidities and death for all characteristic groups of ALL and AML.ResultsThe group that was studied was composed of 577 ALL and 266 AML patients. For both, most patients were male, with a schooling period of 1-4 years, received60 years old and with family history of the disease had the highest risk of developing comorbidities (OR = 5.06, p = 0.038; OR = 2.44, p = 0.041, respectively). Furthermore, patients with ALL and in the 41-50-year age group had a higher risk of death (OR = 31.12; p = 0.001). No association between death and explanatory variables were found in patients with AML. In addition, significant difference was observed in time to death (chi2 = 4,098.32, p = 0.000), with 50% of patients with AML dying within two years after diagnosis, whereas in ALL, this percentual of death only is reached in approximately 5 years.ConclusionOur study describes the data of patients with acute leukemia in Amazonas, a remote region in the north of Brazil. In addition, it highlights the importance of hemovigilance in an Amazon region state, while focusing on peripheral areas which don't have prevention, diagnosis and treatment tools for this disease.
Databáze: OpenAIRE
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