Acute nonlymphoblastic leukemia in adults: Experience in Tripoli, Libya

We conducted a study of 54 adult patients with acute nonlymphoblastic leukemia that was diagnosed over a 5-year period at Central Hospital, Tripoli, Libya. The majority of patients presented with anemia, fever, petechiae, and retinal hemorrhages. Our patients were younger (median age, 34 years) and the disease was more advanced at the time of presentation than that seen in the West. Thirty-seven patients were given induction chemotherapy comprising cytosine arabinoside, daunorubicin, and 6-thioguanine. Fifteen patients (40%) achieved complete remission, with a median survival of 40 weeks. There was partial remission in another 11 patients (30%), and 17 patients died before chemotherapy was begun. Overall long-term results were generally poor. Common causes of death were septicemia and intracranial hemorrhage. There were practical difficulties in carrying out autologous and allogenic bone marrow transplantation, as patients had to be referred abroad. Facilities for treating patients with acute leukemia need to be improved.