Acute and Chronic Leukemia in Sub- Saharan Africa: A Systematic Review

Abstract

Background: The four primary subgroups of leukemia include chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic lymphocytic leukemia (CLL). Very little is known about the regional variation of leukemia and subtypes in sub- Saharan Africa (SSA). Aims: This systematic review focused on the prevalent cases reported in sub- Saharan Africa, throwing more emphasis on treat ment outcomes, follow up time and survival rates. Methods: A systematic review of studies on acute and chronic leukemia in sub- Saharan Africa (SSA) was conducted using ar ticles retrieved from PubMed, Scopus, Google Scholar, Embase and African- specific databases such as African Journals Online (AJOL), covering publications from 1975 to July 15, 2025. Results: A total of 94 studies were subjected to initial screening from study titles. Thirty- two (32) articles that met the inclusion criteria were selected for inclusion in this systematic review. Out of 2537 leukemia cases reported in the 32 studies, 1644 (64.80%) were acute and 893 (35.20%) were chronic. AML accounted for 947 (37.33%), 450 (17.74%) were ALL, 720 (28.38%) were CML, 173 (6.82%) were CLL, 2 (0.08%) were acute undifferentiated leukemia, 1 (0.04%) was mixed phenotype acute leukemia and 244 (9.62%) unclassified leukemias. Survival rates ranged from 2 weeks to 5 years. Fifty- nine patients were lost to follow up and follow up time ranged from 11 months to 7 years. 273 (10.76%) leukemia related deaths were reported. Conclusion: This review found that acute leukemias were more prevalent than chronic leukemias, with AML emerging as the most frequently reported subtype. Survival durations ranged from a few weeks to five years; however, overall outcomes remained poor, characterized by high mortality rates and substantial loss to follow- up. These findings underscore the urgent need for improved diagnostic capacity, standardized treatment protocols, and strengthened patient monitoring and follow- up systems to enhance leukemia care and outcomes.