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Presenting features and treatment outcomes of chronic lymphocytic leukaemia in a resource poor Southern Nigeria

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 × 109/L with a characteristic immunophenoty...

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Published in:Malawi medical journal 2019-06, Vol.31 (2), p.144-149
Main Authors: Madu, Anazoeze Jude, Korubo, Kaladada, Okoye, Augustine, Ajuba, Ifeoma, Duru, Augustine N, Ugwu, Angela O, Nnachi, Oji, Okoye, Helen Chioma
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container_issue 2
container_start_page 144
container_title Malawi medical journal
container_volume 31
creator Madu, Anazoeze Jude
Korubo, Kaladada
Okoye, Augustine
Ajuba, Ifeoma
Duru, Augustine N
Ugwu, Angela O
Nnachi, Oji
Okoye, Helen Chioma
description 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 × 109/L with a characteristic immunophenotypic pattern amidst other clinical and laboratory features. 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. This is a retrospective study with 8 years data (2010-2018) collected from four different centers. Data was analyzed using SPSS 20.0. 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 × 109/L, with a median absolute lymphocyte count of 86 × 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%. 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.
doi_str_mv 10.4314/mmj.v31i2.7
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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%. 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.</abstract><cop>Malawi</cop><pub>University of Malawi</pub><pmid>31452848</pmid><doi>10.4314/mmj.v31i2.7</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1995-7262
ispartof Malawi medical journal, 2019-06, Vol.31 (2), p.144-149
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1995-7262
language eng
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subjects Adult
Aged
Aged, 80 and over
Alkaline Phosphatase - blood
Antineoplastic Agents, Alkylating
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Aspartate Aminotransferases - blood
Chlorambucil - therapeutic use
Female
Hematology
Humans
Laboratories
Leukemia
Leukemia, Lymphocytic, Chronic, B-Cell - blood
Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy
Leukemia, Lymphocytic, Chronic, B-Cell - mortality
Male
Males
Middle Aged
Nigeria - epidemiology
Original Research
Patients
Phosphatase
Retrospective Studies
Survival Rate
Treatment Outcome
title Presenting features and treatment outcomes of chronic lymphocytic leukaemia in a resource poor Southern Nigeria
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