Prevalence and Clinical Correlates of MYD88 L265P Mutation in Sudanese Patients with Chronic Lymphocytic Leukemia

Background: The MYD88 L265P mutation is well established in lymphoplasmacytic lymphoma and Waldenström macroglobulinemia but is uncommon in chronic lymphocytic leukemia (CLL). Data on its prevalence and clinical significance in African populations are limited. Objectives: To estimate the prevalence of MYD88 L265P mutations in Sudanese patients with CLL and evaluate their association with demographic, clinical, hematologic, and morphological features. Methods: A cross-sectional study was conducted on 100 treatment-naive CLL patients. Clinical staging was assessed using Rai and Binet systems. Mutation detection was performed using allele-specific PCR. Associations between MYD88 status and demographic, hematologic, and morphological variables were analyzed. Results: MYD88 L265P mutations were identified in 6% of patients. Mutated cases were significantly younger than wild-type cases (median 54 vs. 60 years, p=0.041). No association was observed with sex distribution, Rai or Binet stage, white blood cell counts, hemoglobin, platelet counts, or morphology indices, including smudge cells, prolymphocytes, and composite morphology index. Conclusion: The MYD88 L265P mutation occurs in a small minority of Sudanese CLL patients, is associated with younger age, but shows no significant clinical or hematological impact. These findings suggest that MYD88 represents a biologically distinct yet clinically neutral subgroup in CLL. Larger multicenter studies are needed to clarify its prognostic and therapeutic relevance