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Presenting features and treatment outcomes of chronic lymphocytic leukaemia in a resource poor Southern Nigeria
Background Chronic lymphocytic leukaemia is a relatively common haematological malignancy affecting older adults, accounting for about 20% of haematological malignancies in Nigeria. Diagnosis of this disease depends on the demonstration of clonal lymphocytosis > 5 x 109/L with a characteristic im...
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Published in: | Malawi medical journal 2020-09, Vol.31 (2) |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Online Access: | Get full text |
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Summary: | Background Chronic lymphocytic leukaemia is a relatively common
haematological malignancy affecting older adults, accounting for about
20% of haematological malignancies in Nigeria. Diagnosis of this
disease depends on the demonstration of clonal lymphocytosis > 5 x
109/L with a characteristic immunophenotypic pattern amidst other
clinical and laboratory features. Objectives To determine the
predominant clinical and laboratory features of CLL at presentation and
their relationship with patient survival. This study also aims at
examining the relationship between treatment protocol and outcome.
Methods: This is a retrospective study with 8 years data
(2010-2018)collected from four different centers. Data was analyzed
using SPSS 20.0. Results There were a total of 97 cases, with a male:
female ratio of 1.1:1. The median age at presentation was 59 years.
Approximately 55% of the patients presented at Binet stage C, with
splenomegaly in 93.2% and 78% were anaemic. The mean white cell count
was 137.9 ± 14.7 x 109/L, with a median absolute lymphocyte count
of 86 x 109/L. The commonest treatment regimen was chlorambucil and
prednisolone and males had a superior response. The number of
chemotherapy cycles, serum alkaline phosphatase and aspartate
transaminase correlated positively with duration of survival. Mortality
rate over the five year period was 14.3%. Conclusion CLL was found to
present in younger patients when compared to previous studies with a
median age of 57 years at diagnosis. Our study showed a slight female
preponderance and better response to therapy in males. Majority of the
patients presented in Binet stage C and were treated with
chlorambucil-based drug combinations compared to more current treatment
with Fludarabine-based combinations. A high serum alanine transaminase
and alkaline phosphatase was found to positively correlate with
survival amongst this patient population |
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ISSN: | 1995-7262 |