CHRONIC MYELOID-LEUKEMIA IN ADULT ETHIOPIANS - ANALYSIS OF 233 CASES

Between January 1982 and December 1993 two hundred and thirty-three co nsecutive cases of chronic myeloid leukaemia were seen in adult Ethiop ians in the Tikur Anbessa Hospital. These cases were studied to descri be the clinical and laboratory features, response to treatment and fol low up status.;the age range was 14-73 (mean 37.2) years. The male to female ratio was 2.2:1. The commonest symptoms were left upper quadran t abdominal mass, weight loss, generalized weakness, fever and Sweatin g. The commonest signs were splenomegaly, sternal tenderness, pallor a nd hepatomegaly. The haematological findings were anaemia (mean Hgb = 10.4 gm/dl) and leucocytosis (mean WBC count = 270,000/mm(3)). The mea n platelet count was 236,000/mm(3). The serum uric acid was raised in the majority of the patients (mean 7.7 mg/dl). Ninety three per cent o f the patients were treated with chemotherapy and/or radiotherapy. Bus ulfan was used in 71.4% of the patients treated, and produced complete and partial remissions in 46.5% and 49.7% respectively, and no respon se in 3.8%. Radiotherapy and cyclophosphamide produced complete remiss ion in only 8.8% and 5.6%, respectively. One hundred and twenty seven patients were lost to follow up Fifty-eight died, and 48 were on follo w up. The median follow up time for the whole group was 42 months. For ty-four patients died before the median follow up time. The median sur vival has not been reached due to loss of a large number of patients t o follow up. The causes of death were blastic transformation, accelera ted phase, splenic infarction and bone marrow suppression. leukaemia i s the commonest type of leukaemia in our institution. Therefore, its m anagement must be strengthened.