Chronic lymphocytic leukaemia at Kenyatta National Hospital with a review of llterature

Abstract

A study to find out the main clinical features of present ation, the clinical course, and laboratory f ind ings for patients with chronic lymphocytic Ieukemi a (eIL), as seen at Kenyatta National Hospital (KNH), Nairobi was carried out during the calender year 1981. Also done, was a review of literature on this disorder. The study period covered the years 1976 to 1981 both inclusive. A total of 42 patients were studied, 29 of them retrospectively and 13 prospectively. TIlere were 29 males and 13 females providing a sex ratio of 1:2.2 (F:M). The age range was J.7to 78, with a mefu'1of 54±14 (1 SD). All the patients were of African origin. The most frequent clinical sign was splenomegally - present in 80% of the patients. Hepatomegally and lymphadenopathy was noted in 76% and 64% respectively. Abdominal pains and dtscomtor-t was the most frequent symptom and was recorded in 52% of the patients. Concurrent infections was corrrron, 81% had detectable respiratory infections; among whom 23% had pulmonary tuberculosis. Hemoglobin values below 12 G:n/dl was recorded in 7'Z70of the patients. Nearly 1/3 had absolute lymphocyte count above 100,000 per mm3^ Disease stagi.ng (according to Rai, 1975) revealed no patient in stage 0, 26% In stages I and II, and 75% in stages III and IV combined. 35% of the patients were seen within six months of the onset of symptoms, while 42% presented after 6 months. Patient compliance was poor with a default rate of 69% noted in this study. 21% were still being followed up at the clinic by the close of the study. 4 deaths, constituting 9% of the patients were noted. Chest infections and ill1ernia were the main tenninal events. Remission was observed in 66% of 18 patients of whom there was adequate data to enable labelling as remission. Most patients were treated with Chlorambucil and Prednisone. The study is concluded with a resume of a case report of a patient who had very severe disease ill1dmultiple complications.