Prevalence and Risk Factors of Iron Deficiency Anemia in Acute Leukemic Patients at Lancet Clinical Laboratory from January 2023 to December 2023

Abstract

Acute leukemias, comprising acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), are hematological malignancies characterized by uncontrolled proliferation of immature blood cell precursors. Anemia is common in acute leukemia patients due to direct marrow infiltration, impaired production, hemolysis, bleeding, and chemotherapy side effects. Specifically, iron deficiency anemia (IDA) further impedes the compromised erythropoiesis in leukemia and exacerbates symptoms like fatigue, dyspnea, and reduced quality of life if not promptly corrected. This study aimed to define the demographics and hematological profile of acute leukemias at Lancet Clinical Laboratories, determine the prevalence and correlates of IDA, and inform clinical risk assessment and management strategies. This retrospective analysis examined 359 records which was obtained from a non probability sampling method via census of which 316 were acute leukemia patients aged 0-90 years diagnosed from January-December 2023. Key variables analyzed included age, sex, residence, leukemia subtype, red cell parameters like hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), and concurrence of IDA based on standard hematological criteria. Descriptive statistics were used to determine IDA prevalence by demographic factors and leukemia type. The analysis of acute leukemia cases at Lancet Clinical Laboratories reveals several notable findings. Acute leukemias make up the large majority (88%) of leukemia cases, with acute myeloid leukemia (AML) being slightly more prevalent than acute lymphoblastic leukemia (ALL). Iron deficiency anemia (IDA) is common, occurring in 127 out of 316 acute leukemia patients. IDA is more prevalent among females, younger patients, those with rural residence, and AML subtype. Advanced disease features like low hematocrit and high blast counts also correlate with higher IDA rates. The hematologic indices show microcytic anemia is common in AML, indicating iron deficiency. Both major subtypes demonstrate reduced hemoglobin content according to low mean corpuscular hemoglobin (MCH). Mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) are also generally low The heavy acute leukemia burden and IDA prevalence highlights needs to strengthen oncological and anemia management pathways. Clinical screening/monitoring protocols should target high-risk groups like females, adolescents, rural communities, and AML patients. An integrated, evidence-based approach enables risk-based, proactive care improving outcomes and reducing complications. Findings provide seminal local statistics on acute leukemias, reveal subgroups disproportionately impacted by IDA based on intrinsic and external factors, demonstrate associations between disease characteristics and hematological indices, and substantiate the imperative for comprehensive guidelines supporting prompt IDA identification and treatment in this population. Prospective longitudinal cohorts incorporating broader nutritional, socioeconomic, molecular variables and longer-term outcomes could enrich understanding and determine optimal, cost-effective management strategies suited for the local context. Ultimately rigorous population-based research is essential to inform meaningful policy and practice advances.