Acute Lymphoblastic Leukaemia: A Case Report of Long-term Disease-free Survival in a Resource Limited Setting

Acute Lymphoblastic Leukaemia (ALL) a malignant proliferation of immature lymphoid cells is a biologically heterogeneous disorder with variable outcomes in adults. We present a case report of a 54 year old woman who presented with fever, anaemia and peripheral lymphadenopathy of four weeks duration, and was managed for disseminated tuberculosis initially. Full blood count and bone marrow aspiration cytology constituted part of her initial investigations and were found to be in keeping with acute lymphoblastic leukaemia (ALL-L3). Patient had supportive treatment and managed with Cyclophosphamide, Vincristine (Oncovin), Cytosine Arabinoside and Prednisolone (COAP Regimen), achieved complete clinical and haematologic remission, and has remained disease free after consolidation and maintenance therapy. No evidence of haematologic or clinical relapse at five years and currently in her ninth-year post diagnosis and treatment. With high index of suspicion, timely investigation and referral, satisfactory outcomes are achievable in managing some patients with acute lymphoblastic leukaemia.