Hairy cell leukaemia in the Bloemfontein academic hospitals.

OBJECTIVES: To study the clinical presentation, treatment and outcome of patients diagnosed with hairy cell leukaemia (HCL) in the Bloemfontein Academic Hospitals during the past 21 years. DESIGN: Retrospective study. All HCL patients diagnosed from 1975 to 1996. SETTING: Haematology clinics of the Universitas and Pelonomi Hospitals in Bloemfontein. SUBJECTS: All HCL patients diagnosed from 1975 to 1996. MAIN OUTCOME MEASURES: To determine the clinical and demographic profile, as well as response to treatment, of HCL patients in this region. RESULTS: A total of 16 HCL patients were studied. There were more males (13) than females and the mean age of the patients was 58 years (35 to 82 year; SD14.8). No Black patients were diagnosed. The patients mostly presented with a cytopenia and splenomegaly was present in 12 of the 14 patients for which spleen size was noted. All of the patients had a splenectomy and six were also treated with 2'-deoxycoformycin (Pentostatin). All six of the patient showed a response to treatment with this purine analogue. CONCLUSIONS: The presentation of HCL in the Bloemfontein academic hospitals is similar to what is seen world-wide. However, to evaluate the durability of the response to treatment with the purine analogues. Long term follow up is needed.

Chronic lymphocytic leukaemia in the Bloemfontein academic hospitals.

OBJECTIVE: To study the clinical presentation, treatment and outcome of patients diagnosed with chronic lymphocytic leukaemia (CLL) in the Bloemfontein academic hospitals during the past 21 years. DESIGN: Descriptive, retrospective study of clinical records of all CLL patients diagnosed at the Haematology clinics of the Universitas and Pelonomi Hospitals in Bloemfontein from 1975 to 1996. METHODS: Age, sex and race distribution of CLL patients were analysed. The peripheral blood, bone marrow, clinical presentation and stage at time of diagnosis, were studied. Treatment modalities, response to treatment and survival of patients were also analysed. Categorical variables were summarised by frequencies and percentages, and numerical variables by means of percentiles. Subgroup comparisons were done by 95% confidence intervals (CI) for differences in percentages, medians or means. RESULTS: A total of 185 CLL patients were studied. There were more males (62.7%) than females and the mean age of the patients was 63 years (19 to 98 years). Eighty six percent of the patients were older than 50 years. Racial distribution was as follow: 106 White, 77 Black and two patients of mixed race. Black patients more often presented with advanced disease and higher lymphocyte counts. A response to therapy was noted for 118 (82.5%) of the 143 patients who received treatment. A complete remission or partial response was noted for 38 (32.2%) of the patients. CONCLUSIONS: The presentation of CLL in the Bloemfontein academic hospitals is similar to what is seen world-wide. This is the first study describing CLL in a large number of Black patients and demonstrates that although Black patients presented more often at a younger age and had high risk disease, their clinical course and progression according to stage, also correlated with what is described in the literature.