الفهرس 
Early Deaths in Pediatric Acute Leukemia; Trend and Predisposing Factors
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Abstract
Background and objectives: The improving overall survival in childhood acute leukemia mainly due to lower relapse rates has increased attention to the importance of reducing treatment-related mortality, which is mainly a result of infectious causes. The aim of the study was to describe the incidence and risk factors associated with early death (first 42 days in treatment) among children with acute leukemia. Methods: This is a retrospective study that included newly diagnosed patients with acute leukemia who presented to NCI, Cairo University between Jan 2011 to Dec 2013. Patients{u2019} data were collected from their files at the Biostatics and Cancer Epidemiology Department and were analyzed for total and early death rates and proposed cause of death. Results: The study population consisted of 370 patients, 253 with ALL, 100 with AML and 17 with MPAL. The total death rate was 40.5% (n=150) and induction death rate was 19.2% (n=71). AML was accompanied with higher rate of total and induction deaths as they were 58% and 25% respectively as compared to 33.6% and 17.4% in ALL. These early deaths were attributed mostly to infection 64.7% (n=46) and cerebrovascular accidents 18.3% (n=13). Factors associated with early deaths were age below 2 years old (p value=0.008), ANC above 1000/ol (p value=0.002) and status of no complete remission (p value= 0.001). Conclusion: Further attention to prevention and prompt treatment of infection and hemorrhagic complications would be valuable in improving rate of early deaths among our patients