Leukaemia in North-West India

D.K. Shome, K. Ghosh, D. Mohanty, K.C. Das, Department of Haematology, Postgraduate Institute of Medical Education and Research, Chandigarh (India) The paper ‘Patterns of Leukaemias in Jordanians: a study of 378 cases’ by M.S. Tarawneh [1], illustrates certain similarities and differences in the pattern of leukaemias in developing countries. A similar study conducted during the same period (1975–1983), involving 820 cases, at the Postgraduate Institute of Medical Education and Research in Chandigarh which is situated 250 km North West of Delhi, India, also shows (table I) (a) acute leukaemias are commoner than chronic varieties; (b) leukaemias involve younger age groups more commonly than older age groups – in contrast to Western figures; (c) chronic lymphatic leukaemia (CLL) is also the least frequent variety. In contrast to the findings in Jordanians, our study showed as a single group chronic granulocytic leukaemia (CGL) to be the commonest leukaemia in Indians. The highest male:female ratio was present in CLL cases (5.3:1). Our findings were corroborated by other Indian studies [2]. However, it is of interest that reports from Kerala [3], in southern India, show acute lymphoblastic leukaemia (ALL) as the commonest leukaemia – similar to Jordanian study. It would have been of interest to know the incidence of various subtypes of acute leukaemia as classified by French, American & British (FAB) classification in Jordanians. In our study, ‘M2’ subtype was found to be the commonest subtype of acute myelo-blastic leukaemia (AML). In the ALL group the incidence of the different subtypes was similar to that in developed countries, with incidence of the ‘Lf subtype being almost double that of the ‘L2’ subtype in the age groups 2–10 years. We have observed that the pattern of leukaemia incidence in our country is similar to that quoted in studies conducted in western countries before 1950 [4, 5]. It will be quite interesting to observe if there is any change in the pattern of leukaemias in other developing countries in course of time as has been observed in developed countries [1], e.g., a significant rise in leukaemia incidence among older age groups and diminishing male preponderance. References Tarawneh, M.S.: Patterns of leukaemias in Jordanians: a study of378cases. Actahaemat. 72: 335– 339(1984). Advani, S.H.; Jussawalla, D.J.; Nagaraj Rao, D.;Gangadharan, P.; Shetty, P.A.: A study of 1126 leukaemia cases. Epidemio-logic and end-result analysis. Indian J. Cancer 16: 8–17 (1979). Verghese, P.R.; Elayidom, N.B.; Joseph, CD.; Kumar, S.: Epi-demiological observations on leukaemia in Kerala (a study of 1016 cases over three years). Indian Haematol. 2: 2(1984).