Leukemias: Epidemiological, Diagnostic and Therapeutic Aspects in Patients Followed at the National Hospital of Niamey

Objective: Improve the care of patients followed for leukemia by taking stock of the epidemiological, diagnostic, and therapeutic situation in the Onco-Hematology department of the National Hospital of Niamey (HNN). Methodology: This was a retrospective study over a 10-year period from January 2010 to December 2019, combined with a 6-month prospective study from January 2020 to August 2020. We included 445 patients in the retrospective phase and 36 patients in the prospective phase. Results: We identified 481 cases of leukemia during our study period, representing an annual incidence of 48.8 cases. The 31 - 45 age group was the most affected, accounting for 23.5% of cases. Males predominated, representing 59.5% of cases, with a male-to-female ratio of 1.46. Abdominal masses were the most common reason for consultation, occurring in 11% of cases, followed by abdominal pain in 10.8%. Splenomegaly was the most frequent sign of tumor syndrome, observed in 38.5% of cases, followed by lymphadenopathy in 26.3%. Pallor of the skin and mucous membranes were noted in 32.6% of cases. According to the observed paraclinical findings, chronic myeloid leukemia (CML) accounted for 39.3% of cases, compared to 37.4% for acute leukemias (AML), 23.9% for acute myeloid leukemia (AML), 13.5% for acute lymphoblastic leukemia (ALL), and lastly, chronic lymphocytic leukemia (CLL) at 22.3%. The most frequently used chemotherapy regimen Imatinib, administered in 30.4% of cases. Regardless of the type of leukemia, the average survival did not exceed one year. Conclusion: Although leukemias have become curable diseases nowadays, the prognosis remains poor in our developing countries due to both late diagnosis and delayed and inadequate treatment.