Shamebo M, Gebremedhin A
Department of Internal Medicine, Faculty of Medicine, Addis Ababa University, Ethiopia.
East Afr Med J. 1996 Oct;73(10):643-6.
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.
1982年1月至1994年12月期间，在埃塞俄比亚亚的斯亚贝巴的提库尔·安贝萨（黑狮）医院共收治了102例慢性淋巴细胞白血病（CLL）患者。年龄范围为35 - 91岁（平均55.6 +/- 11.08岁）。男女比例为3.6:1。最常见的症状为乏力、体重减轻、发热和盗汗。最常见的体征为淋巴结病、脾肿大和肝肿大。56%的患者处于Rai分期III期和IV期，仅3例患者处于0期。接受化疗的患者中，分别有22.0%和48.8%达到完全缓解和部分缓解。12例患者仍存活并接受了2 - 138个月（中位时间18个月）的随访，69例患者在0 - 132个月（中位时间3个月）后失访，21例患者在诊断后0.5 - 84个月（中位时间2.8个月）死亡。死亡患者中，13例处于IV期，5例处于III期。主要死亡原因是8例不明原因的败血症和7例肺炎。因此，CLL在该中心并非罕见疾病。其临床表现与文献报道的病例相似。由于缺乏化疗药物和支持治疗，无法进行最佳治疗。因此，我们建议转诊中心应具备更好的条件来管理CLL患者。
