Bridging the knowledge Gap: A Systematic Review of Acute and Chronic Leukemia Research in Sub-Saharan Africa – Progress Achieved and Future Directions

Abstract

<title>Abstract</title> <bold>Background: </bold>The four primary subgroups of leukemia include chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic lymphoblastic leukemia (CLL). Very little is known about the regional variation of leukemia and subtypes in sub-Saharan Africa (SSA). A lot of cases go undiagnosed and others diagnosed at latter stages. This systematic review focused on the prevalent cases reported in sub-Saharan Africa, throwing more emphasis on treatment outcomes, follow up time and survival rates. <bold>Methods: </bold>A systematic review of papers published on acute and chronic leukemia in SSA were retrieved from PubMed, Scopus, Google Scholar, and African-specific databases (e.g., AJOL - African Journals Online), from initiation date up until inclusion on the March 31, 2025. <bold>Results: </bold>A total of 79 studies were subjected to initial screening from study titles. Seventeen (17) articles that met the inclusion criteria were selected for inclusion in the systematic review. Out of 932 leukemia cases reported in the 17 studies, 496(53.2%) were acute and 436(46.8%) were chronic. 172(18.5%) were AML, 262(28.1%) were ALL, 421(45.2%) were CML, 15(1.6%) were CLL, 2(0.2%) were acute undifferentiated leukemia, 1(0.1%) was mixed phenotype acute leukemia and 59(6.3%) unknown acute leukemias. Survival rates ranged from 2 weeks to 3 years. Fifty-eight patients were lost to follow up, follow up time ranged from 11months to 7 years and 165(17.7%) deaths were reported <bold>Conclusion: </bold>Leukemia is prevalent in sub-Saharan Africa but diagnostic and treatment challenges contribute to the low prevalence reported in the region. We therefore recommended enhancing laboratory and diagnostic facilities as well as providing access to contemporary diagnostic tools such as molecular diagnostics, cytogenetic testing, and flow cytometers; and implementing continuous professional development programs to train healthcare providers. <bold>Systematic Review Registration</bold>: The protocol for the study has been registered in PROSPERO with the following ID number: CRD420251025330.