Chronic leukaemia: an African experience

Abstract

One hundred and eighteen patients with chronic leukaemias were seen at the Lagos University Teaching Hospital, Nigeria, between 1964 and 1982. There were 75 patients with chronic granulocytic leukaemia (CGL) and 43 patients with chronic lymphocytic leukaemia (CLL). Although most of them presented with the familiar features of chronic leukaemias, a few features were remarkably different from those reported in some of the Caucasian series. CLL is less common than CGL in contrast to their relative incidence in Caucasians. Our patients generally presented with more massive splenomegaly and more severe anaemia, which could be attributed to late presentation, endemic malaria and possibly increased hypersplenism. The peak-age incidence in our patients with CGL was found in a younger age group (20-40 yr) than in the Caucasian series. When compared with a Caucasian series, our CGL patients on presentation had a significantly higher proportion of immature cells (blasts and promyelocytes) (P less than 0.05), probably reflecting their more delayed presentation. Follow up was generally poor as a result of a high default rate. Survival duration of both leukaemias was generally lower than in Caucasian series and for CGL patients there was a significant negative correlation between survival and spleen size at presentation, while for CLL patients there was a significant association between poor survival duration and high white cell count at presentation.