Chronic lymphocytic leukaemia in Ghana: clinical and epidemiological insights from a 13-year retrospective review

The clinical and epidemiological characteristics of chronic lymphocytic leukaemia (CLL) in sub-Saharan Africa are not well defined. This study describes the clinical and demographic characteristics of patients with CLL presenting to a tertiary hospital in Ghana, highlighting patterns of presentation and laboratory findings at initial diagnosis within a resource-limited setting. A retrospective case series of all 53 patients diagnosed with CLL between 2012 and 2024 at the Haematology Department of Korle-Bu Teaching Hospital was conducted. Demographic data, clinical presentation, laboratory findings and stage of the disease at diagnosis were extracted from medical records and analysed. The median age at diagnosis was 64 years with a female-to-male ratio of 1.3:1. Patients aged ≤ 55 years accounted for 31% of the cohort. Constitutional symptoms were present in 84.9% of patients, with weight loss being the most common, occurring in 71.7% either alone or in combination with fever and/or night sweats. Splenomegaly was the most common primary presenting feature occurring in 47.2% of patients, with a mean (SD) spleen size below the left costal margin of 13.6 (6.1) cm. Males had significantly higher mean (SD) lymphocyte percentages than females (85.4 [4.3] % vs. 73.3 [8.6] %), whereas females had significantly higher mean (SD) lactate dehydrogenase levels (730.0 [467.3] vs. 451.7 [347.5] U/L). Binet stage C disease was present in 68% of patients at diagnosis. CLL in our case series was frequently diagnosed at an advanced stage, with splenomegaly and weight loss being common presenting features. Significant sex differences were observed in lymphocyte percentage and lactate dehydrogenase levels. These findings highlight the substantial disease burden at diagnosis and underscore the need for enhanced awareness among physicians/healthcare professionals and the public.