Hematological Profile of Pediatric Acute Leukemia Patients: A Cross-Sectional Study in a Tertiary Hospital, Zimbabwe

Abstract

Background: Acute leukaemia is the most common childhood malignancy and a major cause of morbidity and mortality among children worldwide. In Zimbabwe, data on haematological characteristics of paediatric leukaemia are limited, yet such profiling is essential for diagnosis, prognostic assessment, and treatment monitoring. Aim: This study aimed to describe the hematological profiles of pediatric patients with acute leukemia at Parirenyatwa Group of Hospitals, Harare. Methods: A hospital-based cross-sectional study was conducted from January to September 2024. Clinical and laboratory records of children aged 0–17 years diagnosed with acute leukaemia were reviewed. Data on age, sex, genetic factors, and haematological parameters (haemoglobin, platelet count, red and white blood cell counts) were collected. Frequencies and percentages were used to describe categorical variables, while continuous variables were summarised using proportions and compared across acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). Results: A total of 44 children were included, of whom 26 (59.1%) were female and 18 (40.9%) male. The most affected age group was 0–4 years (43.2%), while adolescents (15–17 years) accounted for 22.7%. AML was more common (56.8%) than ALL (43.2%). Genetic predispositions were observed, with Down syndrome (13.6%) and neurofibromatosis (20.5%) strongly associated with AML. Haematological abnormalities included anaemia (80%), thrombocytopenia (78%), and low red blood cell counts (70%). Leukocytosis was present in 60% of patients, particularly in AML. Persistent cytopenias were observed during chemotherapy, with thrombocytopenia (up to 80%) and anaemia (70%) remaining prevalent across treatment intervals. Conclusion: Paediatric acute leukaemia at Parirenyatwa Group of Hospitals is marked by a predominance of AML, early childhood onset, and severe haematological abnormalities. Persistent cytopenias during treatment reflect both disease and therapy-induced marrow suppression, highlighting the urgent need to strengthen diagnostic capacity, supportive care, and access to advanced laboratory testing to improve outcomes in Zimbabwean children with leukaemia.