Epidemiology, Presenting Features and Treatment Outcomes of Patients With Chronic Lymphocytic Leukemia (CLL) in Tanzania

Vollständiger Abstract

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ABSTRACT Chronic lymphocytic leukemia (CLL) is a hematological malignancy of mature clonal B‐cells commonly affecting elderly patients. Novel targeted therapies have improved survival, with 5‐year overall survival (OS) approaching that of the general population. However, data from Sub‐Saharan Africa, including Tanzania, remain scarce, and the epidemiology, clinical presentation, and treatment outcomes are poorly defined. We conducted a retrospective review of all patients diagnosed with hematological malignancies at the National Referral Hospital in Tanzania between January 2010 and December 2022, based on morphological assessment of peripheral blood or bone marrow aspirates. Data were analyzed using STATA v17. Descriptive statistics summarized patient characteristics. Trends in diagnosis were assessed using chi‐square and linear regression. Survival was estimated by Kaplan–Meier and predictors of mortality analyzed using Cox regression. Of 2751 patients diagnosed with hematological malignancies, 174 (6.3%) had CLL. CLL diagnoses increased significantly over time, with an average annual rise of 0.9% ( p = 0.001). Median age at diagnosis was 65 years (IQR 58–72), with a male‐to‐female ratio of 1.3:1. Most patients (71.9%) presented with advanced disease (Rai stage III/IV). Of the 174 patients, 144 received treatment, predominantly chlorambucil plus prednisolone (70.1%). Median OS was 3 years, with a 5‐year OS of 32.7% (95% CI 22.9–42.9), and 62% of patients died within 5 years. Untreated patients had a 2.5‐fold higher hazard of death compared to the treated patients. CLL is an uncommon hematological malignancy in Tanzania, presenting at a slightly younger age and predominantly with advanced disease. Outcomes remain poor with chlorambucil‐based therapy, underscoring the urgent need to strengthen diagnostics and expand access to effective targeted therapies.