Chronic myeloid leukemia in Nouakchott: epidemiological, clinical, cytological and therapeutic aspects: about 50 cases

Introduction: Chronic myelogenous leukemia (CML), a rare myeloproliferative neoplasms (MPNs) representing 2 to 5% of childhood leukemias and 15% of adult leukemias, according to the 2008 WHO classification and its 2016 update, it constitutes one of the preferred study models of leukemogenesis because tumor cells are characterized by an exchange of chromosomal material: the t (9;22) translocation, which leads to the formation of an abnormal chromosome 22, called the Philadelphia chromosome (Ph). The translocation leads to the formation of the BCR-ABL fusion gene. Material and method: This are a retrospective study with analytical purposes, spread over 5 years (2018-2022), on 50 cases of CML, diagnosed and followed in Nouakchott. Results: a male predominance with a sex ratio of 1.08, the average age was 43 years with extremes between 18 years and 69 years, splenomegaly was present in 94%, anemia was present in 34% of patients. the average white blood cell count was 169,364/ mm3, all patients presented myelemia associated with PMNs in the blood smear, the search for the Philadelphia chromosome (BCR/ABL) was positive in all patients, the evolution was favorable in 64%, death occurred in 12%. Conclusion: The diagnosis of CML, although it is always mentioned on the clinical arguments (age, splenomegaly) and haematometric (hyperleukocytosis and myelemia), currently requires to be confirmed, either by the search for the Ph chromosome in cytogenetics, which allows in addition to detecting additional chromosomal anomalies or by FISH method which also makes it possible to detect cases of masked Ph and deletions of ABL, or by molecular biology by qualitative RT-PCR method allowing to detect with certainty the transcript of BCR/ABL.