Leukaemias in Africa

Area of Science:

• Hematology
• Epidemiology
• Oncology

Background:

• Childhood acute lymphoblastic leukemia (cALL) was uncommon in sub-Saharan Africa but now shows a peak incidence in 3-5 year olds in West and Southern Africa.
• Acute myeloid leukemia (AML) has a high incidence in male children (5-14 years), with up to 25% presenting with chloroma.
• Chronic myeloid leukemia (CML) shows no specific epidemiological features but is frequent in young adults and children.
• Two forms of B-cell chronic lymphocytic leukemia (B-CLL) exist: one in women of low socioeconomic status, possibly linked to infections, and another over 45 years, with male predominance.

Purpose of the Study:

• To describe the epidemiological features of various leukemias in sub-Saharan Africa.
• To highlight emerging trends and risk factors for childhood and adult leukemias.
• To discuss the prognostic challenges and potential causes of leukemia in the region.

Main Methods:

• Epidemiological analysis of leukemia incidence and demographics.
• Review of clinical, biological, and social factors affecting prognosis.
• Identification of potential environmental and lifestyle risk factors for adult AML.

Main Results:

• cALL incidence is increasing in sub-Saharan Africa, particularly in young children, with poor outcomes.
• AML is prevalent in young males, and adult incidence may rise due to environmental exposures and treatments.
• B-CLL exhibits distinct epidemiological patterns based on age, sex, and socioeconomic status.

Conclusions:

• Leukemia epidemiology in sub-Saharan Africa is evolving, with specific patterns for cALL, AML, CML, and B-CLL.
• Prognosis for African cALL patients is poor due to multifactorial issues.
• Environmental and lifestyle factors are potential contributors to rising AML incidence in adults.