Title: Poor diagnostics and diagnostic techniques of Acute Myeloid Leukemia leads to poor prognosis is western Kenya

Biography:

Rugut Philemon Kipyego, BSc. Medical laboratory sciences from Mount Kenya University and pursuing an MSc. in medical Hematology, at the school of health sciences, Maseno University, Kenya. I am a laboratory manager at Kapsabet county referral hospital, a Peripheral Blood Film mentor to all Laboratory officers in the western region, and Laboratory Auditor for Quality Assurance, and have experience in hematological analyzer validation and calibration. Currently, analyzing research on mutation in Acute Myeloid Leukaemia among a cohort of the African population at Moi Teaching and Referral Hospital, Kenya

Abstract

Acute myeloid leukaemia (AML) is a group of haematological diseases, characterized by abnormal accumulation of blast cells in the bone marrow and peripheral blood. The disease has a mutable prognosis and a high mortality rate: 5-year overall survival is lesser than 50%, and in elderly patients, only 20% will survive for 2 years after diagnosis. Two systems currently exist to diagnose and classify AML: the French American British (FAB) and the World Health Organization (WHO) classifications. The FAB classification system dates to 1976 and specifies a diagnosis of AML when there is greater than 30% blast population in the peripheral blood and bone marrow. 2008 WHO revision classifies neoplasms based on morphologic cytogenetic, clinical, and phenotypic criteria. They define AML as a myeloid neoplasm with a greater than 20% blast population in the peripheral blood and bone marrow. Hematology facilities in sub-Saharan Africa are still insufficient; few centres in the region can provide specialist care and training. There is a lack of skilled personnel. Few haematological specialists are overwhelmed, in this region, they fall below WHO’s target of one haematologist per 100 000 people, while the laboratory technologists are unskilled in reading and reporting Peripheral blood film (PBF). Most of these technologists cannot identify a real blast cell in a PBF. There is a lack of advanced diagnostic tools like digital microscopes and flow cytometers for analysis to identify acute myeloid leukemia in the facilities within this region. In this presentation, I intend to discuss how to best implement screening programs, how to improve early detection rates and guarantee access to treatment, and how to deliver effective, locally appropriate care. The discussion will also cover blood transfusion, cost-effective treatment for many AMLs, and a key component to providing acute hematological care that is still not explicitly covered in any healthcare programs in the region. The presentation advocates for the need to invest in research and clinical care in Hematology, analyze key challenges in this region and programs that succeeded in improving care in the past years, and provide recommendations to help specialists working in sub-Saharan Africa to provide tailored, evidence-based care in the region. To improve the diagnosis of AML, innovative intervention strategies must be developed and implemented. Investing in training healthcare workers for better diagnostics and developing Hematology services in sub-county, county, and county referral hospitals in this region will be key to realizing my vision of longer and healthier lives for all Africans in the western Kenya region. We also hope that the Series' recommendations will serve as a guide and inspire young Kenyan researchers and healthcare professionals in this, the youngest region in the world, to lead the change and improve hematological care for future generations.