Chronic lymphocytic leukaemia: a-twenty-years experience and problems in Ile-Ife, South-Western Nigeria

L Salawu, R Bolarinwa, M Durosinmi

Abstract

Aim: To investigate the usefulness of some clinical and laboratory parameters in assessing the prognosis and survival of CLL in a resource-limited setting.

Methods: Between September 1986 and March 2007, 79 consecutive patients were retrospectively studied. Diagnosis was based on clinical and haematological findings.

Results: A total of 79 patients, aged 30 to 81 (median = 60) years were managed. There were 34 males and 45 females (ratio = 0.8:1). About 86.1% were aged above 50 years. Massive splenomegaly and  hepatomegaly were recorded in 70.9% and 29.1% of patients, respectively. More than 63% presented in stage C. Anaemia was recorded in 74.7%. Haematocrit correlated negatively with WBC but positively with platelet count. The spleen correlated positively with liver. The overall survival at 2 years was 70.2%. Logistic regression showed that younger age, male sex, higher haematocrit, and lower platelet count improved survival, while lower WBC, moderate hepatomegaly and splenomegaly conferred survival advantage.

Conclusion: It could be concluded that massive splenomegaly is a common finding in the majority of our patients. Non availability of immunophenotyping facility is a major constraint.

Keywords: CLL, diagnostic problems, resource-limited setting