Chronic lymphocytic leukaemia in Ethiopians

One hundred and two cases of chronic lymphocytic leukaemia (CLL) were seen at the Tikur Anbessa (Black Lion) Hospital, in Addis Ababa, Ethiopia, from January 1982 to December 1994. The age range was 35-91 (mean 55.6 +/- 11.08) years. The male to female ratio was 3.6:1. The commonest symptoms were weakness, weight loss, fever and sweating. The commonest signs were lymphadenopathy, splenomegaly and hepatomegaly. Fifty six per cent had Rai stage III and IV, only three patients were in stage 0. Of those treated with chemotherapy, 22.0% and 48.8% achieved complete and partial remissions respectively. Twelve patients are still alive and on follow up for 2-138 (median 18) months, 69 are lost to follow up after 0-132 (median 3) months and 21 are dead 0.5-84 (median 2.8) months after diagnosis. Of those that died, 13 were in stage IV and five in stage III. The main causes of death were septicaemia of undetermined origin in eight and pneumonia in seven. Thus CLL is not a rare disease in this centre. Its presentations are similar to cases reported in the literature. Optimal treatment is not possible due to lack of chemotherapeutic agents and supportive care. Therefore, we suggest that referral centres be equipped for better management of CLL patients.