During the study period, 418 leukemia cases met the inclusion criteria, corresponding to an annual frequency of 48.8 cases. The majority of patients were aged between 31 and 45 years, accounting for 23.5% (n = 113). The mean age was 39.90 years, with a range of 1 to 90 years. Males predominated, representing 59.5% (n = 286), while females accounted for 40.5% (n = 195), resulting in a sex ratio of 1.46. The socioeconomic status was moderate in 23.5% (n = 113) of cases.

The tumor syndrome was the most common clinical sign, observed in 84.9% (n = 408) of cases, with splenomegaly in 38.5% (n = 184) followed by lymphadenopathy in 26.3% (n = 127). Multiple-site lymphadenopathy was the most frequently reported, accounting for 15.6% (n = 75), followed by axillary lymphadenopathy in 7.7% (n = 37). Stage IV splenomegaly was predominant in 20% (n = 96) of cases. Pale skin and mucous membranes were documented in 32.6% (n = 156). Infectious syndromes with pulmonary involvement were identified in 10.6% (n = 51) of cases.

A hemorrhagic syndrome characterized by bruising (a) and petechial (b) in respectively 30.26% (n = 115) each (Figure 1).

Figure 1. Hemorrhagic syndrome ((a): Bruise and (b): Petechiae).

Anemia was reported in 290 patients (60.3%). Leukocytosis was present in 271 patients (57.4%). Thrombocytopenia was documented in 31.6% (n = 152) of cases. Blood immunophenotyping was performed in 287 patients and supported a diagnosis of Acute Lymphoblastic Leukemia (ALL) in 13.5% (n = 65), Acute Myeloid Leukemia (AML) in 23.9% (n = 115), and Chronic Lymphocytic Leukemia (CLL) in 22.3% (n = 107). Molecular biology testing was conducted in 189 patients and identified the BCR-ABL transcript, confirming Chronic Myeloid Leukemia (CML).

Chronic Myeloid Leukemia (CML) was the most frequent leukemia, accounting for 39.3% (n = 189) of cases, including 1 case in blast phase and 12 cases in accelerated phase. Acute Lymphoblastic Leukemia (ALL) was diagnosed in 65/418 cases. Acute Myeloblastic Leukemia (AML) was diagnosed in 115/418 cases.

Figure 2. Distribution of patients by leukemia type.

Given economic constraints, the feasible treatment strategies included: the R-CHOP protocol for some cases of CLL, Imatinib for CML cases, MARALL for ALL cases, and subcutaneous cytarabine for AML cases. In addition to symptomatic treatment and intensive care support, CML cases were treated with Imatinib, with a median survival of 250 months (Figure 3).

Figure 3. Mean survival of CML cases.

AML cases received only subcutaneous cytarabine, with a mean survival of 4 months (Figure 4).

Figure 4. Mean survival of AML cases.

CLL cases were treated with R-CHOP, with a mean survival of 34 months (Figure 5).

Figure 5. Mean survival of CLL cases.

An annual frequency of 48.8 cases was observed. This is higher than the rates reported by THIAM et al. in Dakar, Diallo et al. in Mali, and TEA D et al. in Côte d'Ivoire, which were 30, 33, and 43.2 cases per year, respectively [7]-[9]. It is also higher than the rate of 9.8 cases per year found by Dicko in Mali [10]. This difference may be explained by the fact that our study included all patients regardless of age. A male predominance was noted, with a sex ratio of 1.46, while Dicko reported a sex ratio of 1.26 [10]. The mean age of our patients was 39.90 years. Messaoudi in Algeria reported an age range of 41 - 50 years [11].

The tumor syndrome was the most frequent clinical sign, occurring in 84.9% of cases, with splenomegaly present in 38.5%. Koulidiati et al. in Ouagadougou reported splenomegaly and lymphadenopathy in 75% and 28% of their patients, respectively [12]. Similar findings have been observed in other African studies [8][10][13][14]. This may be attributed to socioeconomic challenges and subsequent delays in seeking medical consultation.

Anemia was reported in 290 patients (60.3%), leukocytosis in 271 patients (57.4%), and thrombocytopenia in 152 cases (31.6%). Similar findings were reported by Ouédraogo RC in Burkina Faso, Plo KJ et al. in Côte d'Ivoire, and Mbensa L et al. in Kinshasa, Congo [13][15][16]. The high prevalence of anemia may be explained by the poor socioeconomic status of our patients, delays in consultation, and particularly by bone marrow infiltration by leukemic cells. Chronic Lymphocytic Leukemia (CLL) ranked third in our series, with 107 cases (22.3%). Nacoulma et al. in Ouagadougou reported a frequency of 13%, while Ouédraogo et al. in 2011 reported a rate of 17.2% for CLL, both based on cytological examination [15][17][18]. Acute Lymphoblastic Leukemia (ALL) was diagnosed in 65/418 cases. Acute Myeloblastic Leukemia (AML) was diagnosed in 115/418 cases. In Niger, Djibrilla-Almoustapha et al. in 2024 reported 16.64% cases of Acute Lymphoblastic Leukemia [19].

The median survival for CML cases was 250 months, while it was 4 months for AML cases and 34 months for CLL cases. Koulidiati T et al. reported lower survival rates than ours [12]. This difference may be explained by the higher prevalence of CML in our study.