Abstract

Research Article

Results of chemotherapy in the treatment of chronic lymphoid leukemia in Black Africa: Experience of Côte d’Ivoire

Packo Dieu-le-veut Saint-Cyr Sylvestre*, N’dhatz Comoe Emeraude, Kamara Ismael, Boidy Kouakou, Nanho Danho Clotaire and Koffi Kouassi Gustave

Published: 27 September, 2019 | Volume 3 - Issue 1 | Pages: 045-048

Background: The treatment of chronic lymphoid leukemia currently uses news drugs which are more expensive in our countries. Its why, the results of chemotherapy remains a challenge in our sector.

Aims: To evaluate the place of polychemotherapy in the treatment of chronic lymphoid leukemia in black Africa.

Methods: It was a prospective, descriptive, analytic and non-comparative study, concerning the records of patients with chronic lymphoid leukemia treated and followed at the department of clinical hematology in Abidjan.

Results: We included 56 patients. The average age was 62 years with extremes of 38 and 84 years. The sex ratio was 0.8 in favor of female. The clinical signs noted a tumor syndrome among which splenomegaly, classified stage III (46, 43%) and adenopathy (64, 29%). Biologically, we observed a blood lymphocytosis (50%), an anemia (39.29%) and a thrombocytopenia (62.50%). The majority of patients were classified stage A of BINET (51.79%). The COP protocol (44.64%) and the monochemotherapy with chlorambucil (39.29%) were the most used. The therapeutic response of polychemotherapy was low (12.5%) compared to 35, 71% for monochemotherapy (p = 0.0001) with overall survival significantly better in monochemotherapy. The outcome of patients used polychemotherapy were more adverse that of patients used chlorambucil alone (p = 0,003). The overall probability of survival at 12 months was 90, 9% for patients who used monochemotherapy and 63, 4% for polychemotherapy.

Conclusion: Polychemotherapy in chronic lymphoid leukemia of black African has an adverse therapeutic response hence the interest of using new therapeutic possibilities.

Read Full Article HTML DOI: 10.29328/journal.acst.1001008 Cite this Article Read Full Article PDF

Keywords:

Chronic lymphoid leukemia; Polychemotherapy; Black Africa  FullText PDF

References

  1. Evrard S, Gaussem P, Helley D, Darnige L. Facteurs pronostiques de la leucémie lymphoide chronique: Apports des marqueurs biologiques récents. Ann Biol Clin. 2015; 63: 589-597.
  2. Société française d'Hématologie. Leucémie Lymphoïde chronique. Hématologie. 2007; 13: 348-351.
  3. Chiorazzi N, Rai KR, Ferrarini M. Chronic lymphocytic leukemia. N Engl Journ Med. 2005; 352: 804-815.
  4. Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer. 1981; 48: 198-206. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7237385
  5. Koffi KG, Nanho DC, Tolo A, N'Dathz E, Kouakou B, et al. La leucémie lymphoïde chronique du Noir en Afrique subsaharienne: caractéristiques cliniques thérapeutiques et pronostiques (cas de la Côte d'Ivoire). Bull Cancer. 2009; 96: 901-916.
  6. Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, el al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on chronic lymphocytic leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. 2008; 111: 5446-5456. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18216293
  7. Bastin Ch. Les leucémies lymphoïdes chroniques; la diversité des cas et leur évolution. Cahiers de l'analyse des données. 1976; 419-440.
  8. Merle B. leucémie lymphoïde chronique: diagnostic, évolution, pronostic, traitement. Rev Prat. 1993; 43: 2713-2717.
  9. Toutoukpo Y, Tea N, Drain J. La leucemie lymphoïde chronique en Cote d'Ivoire (a propos de 69 cas). Med Trop. 1981; 51: 417-420.
  10. Lepretre S, Van Den Neste E. Place de la chimiothérapie dans la leucémie lymphoïde chronique. Hématol. 2006; 12: 28-34.
  11. Jakši B, Pejša V, Ostoji-Koloni S, Kardum-Skelin I, Baši Kinda S, Coha B, et al. Guidelines for Diagnosis and Treatment of Chronic Lymphocytic Leukemia. Krohem B-Cll 2017. Acta Clin Croat. 2018; 57: 190-215. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30256032
  12. CLL Trialists' Collaborative Group. Chemotherapeutic options in chronic lymphocytic leukemia: a meta-analysis of the randomized trials. J Nat Cancer Inst. 1999; 91: 861-868. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10340906
  13. Leblond V, Delmer A. Prise en charge de la leucémie lymphoïde chronique en première ligne. Correspondances en onco-hématologie. 2009; 4: 122-126.
  14. Dighiero G, Maloum K, Desablens B, Navarro M, Leblay R, et al. Chlorambucil in indolent chronic lymphocytic leukemia. French Cooperative Group on Chronic Lymphocytic Leukemia. N Engl J Med. 1998; 338: 1506-1514. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9593789
  15. Jaksi B, Brugiatelli M. High dose continuous chlorambucil vs intermittent chlorambucil plus prednisone for treatment of B-CLL--IGCI CLL-01 trial. Nouv Rev Fr Hematol. 1988; 30: 437-442. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3065740a

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  • Results of chemotherapy in the treatment of chronic lymphoid leukemia in Black Africa: Experience of Côte d’Ivoire
    Packo Dieu-le-veut Saint-Cyr Sylvestre*, N’dhatz Comoe Emeraude, Kamara Ismael, Boidy Kouakou, Nanho Danho Clotaire and Koffi Kouassi Gustave Packo Dieu-le-veut Saint-Cyr Sylvestre*,N’dhatz Comoe Emeraude,Kamara Ismael,Boidy Kouakou,Koffi Kouassi Gustave,Nanho Danho Clotaire,Koffi Kouassi Gustave. Results of chemotherapy in the treatment of chronic lymphoid leukemia in Black Africa: Experience of Côte d’Ivoire. . 2019 doi: 10.29328/journal.acst.1001008; 3: 045-048

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