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History Presentation Templates

Captivating history powerpoint templates and google slides themes with vintage charm are ready to use. step back in time with our 100% customizable presentation slides. engage your viewers with stunning visuals, antique elements, and various historical themes to bring your narratives to life. perfect for educators, students, and historians. explore now.

History

  • Aesthetic Vintage Look: Every history PPT template comes with a touch of nostalgia, perfectly mirroring the era it represents.
  • Captivating Visuals: With our history slides, your audience will be engrossed by the mesmerizing visuals that range from nautical adventures to the medieval era and the art history thesis.
  • Versatility: Whether you're discussing ancient history or specific figures and events, our templates come specialized, so your content always finds a fitting background.
  • Editable Features: Our editable features ensure that every history template becomes uniquely yours to fit the narrative.
  • Diverse Imagery: Our slides are filled with rich visuals that transport your audience back in time.

We're here to help you!

What are history presentation templates.

History Presentation templates are ready-made presentation slides that contain pre-formatted graphics, text, and animation that you can use to create a professional-looking presentation about any historical event, person, or period.

Where can we use these History Slides?

You can use these History Slides for educational activities in a classroom, lectures, seminars, or presentations at conferences or special events. They can also be used as a reference tool for research or as a teaching aid to help explain a specific historical event or period.

How can I make History PPT Slides in a presentation?

Create a PowerPoint with high-quality, high-resolution images. Add color and texture to your slides. Also, use attractive fonts and font sizes to create a unique look for your slides. Suppose you want to learn how to use the PowerPoint tool. Visit Tips and tricks for detailed instructions.

Who can use History Presentation Templates?

Anyone can use History Presentation Templates to create an informative presentation about a historical event or period. They can be used by teachers, students, historians, and museums.

Why do we need History Presentation Slides?

History Presentation slides provide an efficient and effective way to present historical information to a class or audience. They offer a visual representation of the material with images and text.

Where can I find free History Presentation Templates?

Many websites offer free History Presentation templates. Slide egg is one of the best PowerPoint providers. Our websites' uniquely designed templates make your presentation more engaging and visually appealing.

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Free History Templates for PowerPoint and Google Slides

Make your presentations and lessons stand out with these free templates for History .  

Download them to use with PowerPoint or edit them in Google Slides and start creating!

historical background for presentation

Celebrate Women in Style: Free PowerPoint and Google Slides template for International Women’s Day. Mark your calendars, because March 8th is all about celebrating the incredible achievements of women worldwide! This year, elevate your International Women’s Day presentations with this inspiring PowerPoint and Google Slides template. You can showcase the […]

Free PPT & Google Slides Theme for International Women’s Day.

historical background for presentation

Showcase historical figures and highlight key moments in Black history with this free PowerPoint Template and Google Slides Theme February is Black History Month, a time to honor the achievements and contributions of Black individuals throughout history. This year, elevate your presentations with this stunning PowerPoint template and Google Slides […]

Celebrate Black History Month with this free PPT & Google Slides theme.

historical background for presentation

History and Art scrapbook free PowerPoint Template and Google Slides Theme. A walk through art & history free template is perfect for your next history or art presentation. It features a scrapbook style filled with sticker images of famous sculptures and statues, such as Michelangelo’s David and The Winged Victory […]

A walk through art & history free scrapbook presentation template.

historical background for presentation

Free newspaper style presentation template for PowerPoint and Google Slides. A simple template that resembles a newspaper and its sections. And since it’s a newspaper you can use this theme for a large number of subjects. Current affairs and news, economy, leisure, or you can ask your students to write […]

Newspaper style Google Slides and Ppt presentation template.

historical background for presentation

Free Template for PowerPoint and Google Slides MacCarthy MacCarthy is a simple template that resembles an old newspaper. You can use it for a history or journaling lesson. In order to for the images to match its style, once you have inserted your pictures, select them and click on Format Options, […]

MacCarthy Old Newspaper theme for Google Slides and ppt. Updated Template.

historical background for presentation

Old paper and maps free PowerPoint Template and Google Slides Theme for history lessons and presentations. Ready to navigate history? Grab your compass and let’s start this journey! This history template features old paper, maps, a globe and a compass and it’s perfect to talk about the world trough history […]

Old Maps History Lesson free theme.

historical background for presentation

Africa landscapes and animals free PowerPoint Template and Google Slides Theme Africa Viva is perfect to talk about Africa, the savannah or the animal kingdom. It has beautiful sunset colors and papercut style landscapes made with different layers. I’ve included two different title slides, one with the African continent and […]

Africa Viva, free presentation template.

historical background for presentation

China inspired free PowerPoint Template and Google Slides Theme This template was designed by my 12yo daughter. She had to make a presentation for school about Ancient China, so here it’s the result: Cherry blossom trees, a sketch of the Great Wall, lanterns, clouds and even a dragon. All this […]

A Chinese Tale. A China inspired presentation template.

historical background for presentation

Free animated Google Slides and PowerPoint template. Create a presentation that looks like an old movie intro – with countdown and everything! – using this free Google Slides and PowerPoint template. This template features a vintage film reel design with a countdown timer and it is perfect for anyone looking […]

Old movie intro aesthetic free animated presentation template.

historical background for presentation

Free PowerPoint template and Google Slides theme. Harlow is a creative free template to use with Google Slides or download as PowerPoint. It features organic shapes and littles touches of bronze. This free presentation template has organic shapes with different shades of brown with some touches of bronze. Use it […]

Harlow, organic shapes slides template.

historical background for presentation

Free PowerPoint template and Google Slides theme. Celebrate Black History Month slides backgrounds. Black History Month celebrates the contributions that black people have made to the world. Some countries, like US or Canada, celebrate it on February, while others, like the UK do it in October. DOWNLOAD POWERPOINT OPEN IN […]

Black History Month slides presentation theme.

historical background for presentation

Free PowerPoint template and Google Slides theme. Free virtual art gallery to showcase students’ work or to create an interactive lesson. Another special request! This time by Ximena. Given that now most schools don’t allow to display anything on the walls, and that many students are distance learning, she needed […]

Virtual Art Gallery, interactive template.

historical background for presentation

Free PowerPoint template and Google Slides theme. This is a Classified template; you shouldn’t be reading this! Unless you are a SlidesManiac and therefore you are authorized! This free template for Google Slides or PowerPoint is perfect for school activities such us digital breakouts, a history lesson, to investigate a […]

Top Secret, these slides are classified.

0157-Monet-Free-Template-for-Google-Slides-or-PowerPoint-Presentations

Free Template for PowerPoint and Google Slides Presentations Monet Monet free presentation template is, of course, perfect for presentations about art! Even though I chose Monet, you can use images from any other artist. I have found these images on the Art Institute of Chicago website. If you have time, I […]

Monet Free Template for Google Slides or PowerPoint Presentations

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215 Best History-Themed Templates for PowerPoint & Google Slides

With over 6 million presentation templates available for you to choose from, crystalgraphics is the award-winning provider of the world’s largest collection of templates for powerpoint and google slides. so, take your time and look around. you’ll like what you see whether you want 1 great template or an ongoing subscription, we've got affordable purchasing options and 24/7 download access to fit your needs. thanks to our unbeatable combination of quality, selection and unique customization options, crystalgraphics is the company you can count on for your presentation enhancement needs. just ask any of our thousands of satisfied customers from virtually every leading company around the world. they love our products. we think you will, too" id="category_description">crystalgraphics creates templates designed to make even average presentations look incredible. below you’ll see thumbnail sized previews of the title slides of a few of our 215 best history templates for powerpoint and google slides. the text you’ll see in in those slides is just example text. the history-related image or video you’ll see in the background of each title slide is designed to help you set the stage for your history-related topics and it is included with that template. in addition to the title slides, each of our templates comes with 17 additional slide layouts that you can use to create an unlimited number of presentation slides with your own added text and images. and every template is available in both widescreen and standard formats. with over 6 million presentation templates available for you to choose from, crystalgraphics is the award-winning provider of the world’s largest collection of templates for powerpoint and google slides. so, take your time and look around. you’ll like what you see whether you want 1 great template or an ongoing subscription, we've got affordable purchasing options and 24/7 download access to fit your needs. thanks to our unbeatable combination of quality, selection and unique customization options, crystalgraphics is the company you can count on for your presentation enhancement needs. just ask any of our thousands of satisfied customers from virtually every leading company around the world. they love our products. we think you will, too.

Widescreen (16:9) Presentation Templates. Change size...

 Presentation with history - The pyramids of the Egypt with sky in the background

The pyramids of the Egypt with sky in the background

 Presentation with history - The united states of american constitution history of founding fathers values as a metaphor on a neutral background

The united states of american constitution history of founding fathers values as a metaphor on a neutral background

 Presentation with history - Presentation design having history - old american flag background and a tawny brown colored foreground

Presentation design having old american flag on a antique wooden platform - veterans day

 Presentation with history - Old tan maps of the world for travelers planning routes longitude and latitude

Old tan maps of the world for travelers planning routes longitude and latitude

 Presentation with history - Old fashioned gold quill and scroll for history time and past metaphors on brown background

Old fashioned gold quill and scroll for history time and past metaphors on brown background

 Presentation with history - Abu Simbel colossus egypt ancient statues africa

Abu Simbel colossus egypt ancient statues africa

 Presentation with history - Roman Statues depicting historical and mythological figures

Roman Statues depicting historical and mythological figures

 Presentation with history - Colorful PPT theme enhanced with history - light coming from book backdrop and a tawny brown colored foreground

PPT theme enhanced with light coming from book in woman's hands in gesture of giving offering concept of wisdom religion reading imagination backdrop

 Presentation with history - Presentation design consisting of history - genuine old stained world map background and a coral colored foreground

Presentation design consisting of genuine old stained world map dated from the mid 1800's showing western and eastern hemispheres with hand colouring

 Presentation with history - Colorful presentation design enhanced with history - seafront on the sunset backdrop and a wine colored foreground

Presentation design enhanced with seafront on the sunset with viking ship

 Presentation with history - Ancient Egyptian pharoah statues with columns, ruins, archaeology, Egypt

Ancient Egyptian pharoah statues with columns, ruins, archaeology, Egypt

 Presentation with history - Beautiful PPT theme featuring history - fountain pen on an antique backdrop and a lemonade colored foreground

PPT theme featuring fountain pen on an antique handwritten letter

 Presentation with history - Old fashioned hourglass and feather with scroll history

Old fashioned hourglass and feather with scroll history

 Presentation with history - Slides having history - medieval old nautical map background background and a coral colored foreground

Slides having medieval old nautical map background

 Presentation with history - Presentation theme with history - old style movie projector still-life background and a light blue colored foreground

Presentation theme with old style movie projector still-life close-up

 Presentation with history - A castle with clouds in the background and place for text

A castle with clouds in the background and place for text

 Presentation with history - An old fashioned compass with topographic map pointing north east south west on orange and brown background as a metaphor

An old fashioned compass with topographic map pointing north east south west on orange and brown background as a metaphor

 Presentation with history - School report card with A+ grades on math, science, history and English, with envelope, pencil, ruler and opened notebook on black background

School report card with A+ grades on math, science, history and English, with envelope, pencil, ruler and opened notebook on black background

 Presentation with history - Cool new presentation with history - old book selective focus backdrop and a tawny brown colored foreground

Presentation with old book selective focus

 Presentation with history - Colorful PPT layouts enhanced with history - wood texture backdrop and a blonde colored foreground

PPT layouts enhanced with wood texture

 Presentation with history - Theme enhanced with history - old paper manusript or parchment background and a blonde colored foreground

Theme enhanced with old paper manusript or parchment horizontally oriented

 Presentation with history - Colorful PPT layouts enhanced with history - film negative frames background copy backdrop and a lemonade colored foreground

PPT layouts enhanced with film negative frames background copy space

 Presentation with history - Beautiful presentation theme featuring history - mount rushmore backdrop and a lemonade colored foreground

Presentation theme featuring mount rushmore

 Presentation with history - Hourglass old clock time passes history present past future white background

Hourglass old clock time passes history present past future white background

 Presentation with history - Presentation design having history - closeup of a pile background and a mint green colored foreground

Presentation design having closeup of a pile of vintage family photos

 Presentation with history - Toy soldiers with cart on American flag background, military history

Toy soldiers with cart on American flag background, military history

 Presentation with history - Audience pleasing theme consisting of february-black-history-month-handwriting backdrop and a coral colored foreground

Theme consisting of february - black history month handwriting in a desktop calendar an annual observance originating in the united states where it is also known as african-american history month

 Presentation with history - Theme enhanced with conceptual old retro aged paper background and a blonde colored foreground

Theme enhanced with vintage concept conceptual old retro aged paper texture isolated on white background abstract damaged parchment or label as a banner for grunge ornament book letter time pattern history designs

 Presentation with history - Beautiful PPT theme featuring history - independence hall in philadelphia pennsylvania backdrop and a red colored foreground

PPT theme featuring independence hall in philadelphia pennsylvania usa

 Presentation with history - Beautiful theme featuring blank family tree taken closeup backdrop and a lemonade colored foreground

Theme featuring blank family tree taken closeup

 Presentation with history - Audience pleasing slide set consisting of history - fountain pen on an antique backdrop and a lemonade colored foreground

Slide set consisting of fountain pen on an antique handwritten letter

 Presentation with history - Colorful theme enhanced with history - vintage grunge still life vintage backdrop and a tawny brown colored foreground

Theme enhanced with vintage grunge still life vintage items on ancient map

 Presentation with history - Theme having history - close up of europe background and a tawny brown colored foreground

Theme having close up of europe on globe

 Presentation with history - Audience pleasing theme consisting of history - paper and technology backdrop and a tawny brown colored foreground

Theme consisting of paper and technology

 Presentation with history - Egyptian hieroglyphics craved in stone for history

Egyptian hieroglyphics craved in stone for history

 Presentation with history - Cool new presentation design with history - old blank parchment or paper backdrop and a lemonade colored foreground

Presentation design with old blank parchment or paper isolated clipping path is included

 Presentation with history - PPT theme enhanced with history - constitution of the united states background and a yellow colored foreground

PPT theme enhanced with constitution of the united states of america on a wooden desk

 Presentation with history - Cool new theme with history - old style movie projector still-life backdrop and a ocean colored foreground

Theme with old style movie projector still-life close-up

 Presentation with history - The repreentation of stonehenge with a lot of greenery

The repreentation of stonehenge with a lot of greenery

 Presentation with history - Presentation design with literature writing author and history background and a tawny brown colored foreground

Presentation design with quill pen and ink well resting on an old book in a library concept for literature writing author and history background

More history templates for powerpoint and google slides:.

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Home / Free Aesthetic PowerPoint Templates and Google Slides Themes / Free Google Slides History Template PowerPoint

Free Google Slides History Template PowerPoint

history theme presentation template

About the Template

As kids and even today, reading history lessons is the most mundane task. But, being tedious, learning history is important too. Through History lessons, we can better understand past societies, systems, ideologies, governments, cultures, etc.

By studying history, we gain transferable skills, which is undoubtedly one reason why we should learn history. We have Free Google Slides History PowerPoint templates to make your history lessons more interesting. This history background for ppt templates has a historic touch with a vintage-styled background. The template also uses old ship, compass, and library images, giving the template a classic and vintage feel.

Key Features of this free History PowerPoint Template

  • Rich Historical Visuals: This History theme template includes rich historical visuals with a captivating backdrop that includes iconic historical imagery, maps, and artefacts.
  • Educational Icons: Moreover, you will find educational icons that will enhance your lessons with a set of history-related icons, making it easy to illustrate key points and events.
  • Versatile Usage: Perfect for classroom history lessons, historical research presentations, heritage preservation projects, and more.
  • Customization Made Easy: Easy to customize this template to your specific content, whether you’re teaching ancient civilizations or modern history.
  • Accessible Learning: Whether you’re an educator, student, or history enthusiast, this template empowers you to share the rich tapestry of history.

Get this free Slides background and make your learnings more engaging. Also, check our Free Chemistry background if you want to design chemistry projects or notes.

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It is a long established fact that a reader will be distracted by the readable content of a page when or randomised words which don’t look even slightly believable

Classy History Background for PowerPoint Google Slides

Classy History Background for PowerPoint Google Slides

Classy medieval history framed background.

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Elevate your designs with a touch of history! Download your free Classy History Background for PowerPoint, Google Slides, and Wallpaper today.

Today, we’ve got a treat for you – a free, classy, and historically inspired background that’s perfect for PowerPoint, Google Slides, or to jazz up your desktop as a wallpaper. Introducing our “Classy History Background” – a seamless blend of papyrus, old paper , grunge, and antique vibes that will transport your audience to a bygone era.

Unleashing Elegance: Classy History Background

Picture this: you’re giving a presentation on medieval art, vintage aesthetics, or historical events. What better way to captivate your audience than with our Classy History Background for PowerPoint? This masterpiece combines abstract simplicity with a touch of medieval charm, featuring a vintage frame and intricate medieval borders that add an extra layer of sophistication. Your content will stand out, leaving a lasting impression.

Transport Your Audience: Using History Background Across Industries

  • Education : Transform your history lessons into immersive experiences, making facts come to life.
  • Business : Impress clients with presentations that exude professionalism and a timeless aesthetic.
  • Events : Create invitations that set the tone for classy, memorable gatherings.
  • Blogging : Elevate your content with visually striking featured images that keep readers engaged.
  • Social Media : Make your posts stand out with a touch of vintage charm, perfect for any niche.

The versatility of our Classy History Background extends beyond these examples. Whether you’re in the arts, marketing, or simply a lover of beautiful designs, this background is your go-to for adding a touch of class to any project.

Incorporating the aesthetic elements of medieval times, our background is not just a backdrop; it’s a storyteller. The blend of ancient tones and a simple yet elegant design makes it a perfect match for any creative endeavor.

And guess what? It’s completely free! Download your history background now and witness the transformation it brings to your projects.

Aesthetic Elegance Everywhere

Spruce up your presentations, wallpapers, and designs effortlessly with our classy history background. Embrace the beauty of the past while stepping confidently into the future of your creative endeavors.

Download your free classy medieval history background now and infuse your creations with timeless elegance.

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Download the ZIP file and get a free full HD background, designed in the perfect size for your PPT or Google Slides presentation.

You can use this Classy Medieval History Framed Background as a Wallpaper or use it as a background for slides.

Features of Classy History Background for PowerPoint Google Slides

  • High quality jpg image
  • Add the design that best suits your needs
  • This background is designed to be used in Google Slides and Microsoft PowerPoint PPT files
  • 16:9 widescreen format suitable for all types of screens
  • 1920x1080 Full HD also usable as wallpaper

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History Presentation Template

Template preview

AI generated Pitch Deck 🤖

History Powerpoint Templates

Perfect for: historians, history teachers, history speakers, history professors, timelines in powerpoint

Telling a story verbally is one of the most ancient art forms. It has been an inherent part of humanity since the beginning of times. Interestingly, this old capability has become an enormously important quality for different current uses. As well, recent studies and technological advances have put into our general knowledge vast amounts of data that can help us tell the story of human beings.

What is a History Powerpoint  Template?

History has a magical sense, which transports us to ancient or older times where we can only imagine how life was different to what we see today. It doesn´t matter if you need to speak about recent events or whatever happened before the birth of civilization, being able to create an excellently balanced powerpoint presentation is imperative. It might even be the difference between great storytelling and just set up the stage for random pieces of information.

This presentation template will allow a diverse group of people take advantage of the enticing historical information. It has been created not only with text and image information but also data related to each timeline. This might be of great help for creating presentations that respond to academic or industry-specific needs.

The approach for this template is action-inspiring and allows not only speakers but also the audience to see a new de of history they might have missed before.

What should a History Powerpoint Presentation include?

A summary of main information aspects to be shared can be a high starting point. It can also include crucial points of data that can create interest in the period you will be showcasing.

You can provide a general view of what was the current situation at that point and what was influencing change. This would include relevant events, with different types of historical events reviews, and even the changes that happened per period.

Make sure you also include several types of timeline versions that can provide insights on regards of problems and needs for each period. Don't underestimate all kinds of graphs and tables to provide the most significant amount of information.

Which information can you include in a History Powerpoint Template?

Your history timeline in powerpoint can be much more than that by including:

● Significant data that can not only provide a timely development of history but as well numbers for a more robust presentation.   ● Graphics of different kinds that can be more enticing and creative around the historical storytelling you are providing.   ● Provide robust summaries for each term to ensure that there is a clear understanding of the highlights of all the narration. ● Include relevant quotes that represent the views of historians or famous historical figures.

Your timeline narration can be as compelling and surprising to your audience as you allow it to be. Make sure not to stay focus just on images or text but improve this information by making all data available to improve the understanding history. Finally, go ahead and make your history powerpoint presentation the most memorable part.

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History PowerPoint Background, Free History Backgrounds

Best 33 pieces of high-quality and free History powerpoint background images for your PowerPoint Templates.

When designing a new powerpoint presentation, you can be inspired by the background images found here, or you can use the wallpapers, background images found here for your desktop.

All presentation pictures and presentation themes and wallpapers are prepared with great craftsmanship.

Please, remember to link to History powerpoint background page for attribution!

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How to Make a “Good” Presentation “Great”

  • Guy Kawasaki

historical background for presentation

Remember: Less is more.

A strong presentation is so much more than information pasted onto a series of slides with fancy backgrounds. Whether you’re pitching an idea, reporting market research, or sharing something else, a great presentation can give you a competitive advantage, and be a powerful tool when aiming to persuade, educate, or inspire others. Here are some unique elements that make a presentation stand out.

  • Fonts: Sans Serif fonts such as Helvetica or Arial are preferred for their clean lines, which make them easy to digest at various sizes and distances. Limit the number of font styles to two: one for headings and another for body text, to avoid visual confusion or distractions.
  • Colors: Colors can evoke emotions and highlight critical points, but their overuse can lead to a cluttered and confusing presentation. A limited palette of two to three main colors, complemented by a simple background, can help you draw attention to key elements without overwhelming the audience.
  • Pictures: Pictures can communicate complex ideas quickly and memorably but choosing the right images is key. Images or pictures should be big (perhaps 20-25% of the page), bold, and have a clear purpose that complements the slide’s text.
  • Layout: Don’t overcrowd your slides with too much information. When in doubt, adhere to the principle of simplicity, and aim for a clean and uncluttered layout with plenty of white space around text and images. Think phrases and bullets, not sentences.

As an intern or early career professional, chances are that you’ll be tasked with making or giving a presentation in the near future. Whether you’re pitching an idea, reporting market research, or sharing something else, a great presentation can give you a competitive advantage, and be a powerful tool when aiming to persuade, educate, or inspire others.

historical background for presentation

  • Guy Kawasaki is the chief evangelist at Canva and was the former chief evangelist at Apple. Guy is the author of 16 books including Think Remarkable : 9 Paths to Transform Your Life and Make a Difference.

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Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a tertiary care teaching hospital in Addis Ababa, Ethiopia: a cross-sectional study

  • Fekadu Urgessa 1 , 3 ,
  • Boki Lengiso 1 , 6 ,
  • Aster Tsegaye 1 ,
  • Amha Gebremedhin 2 ,
  • Fozia Abdella 2 ,
  • Fisihatsion Tadesse 2 ,
  • Jerald Radich 4 ,
  • Helen Nigussie 3 &
  • Teklu Kuru Gerbaba 3 , 5  

BMC Cancer volume  24 , Article number:  530 ( 2024 ) Cite this article

Metrics details

In low-income countries there is insufficient evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients. Therefore, we performed this study among newly confirmed CML patients at Tikur Anbesa Specialized Hospital (TASH), Ethiopia.

To determine the hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at tertiary care teaching hospital in Addis Ababa, Ethiopia.

A facility-based cross-sectional study was conducted to evaluate hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at TASH from August 2021 to December 2022. A structured questionnaire was used to collect the patients’ sociodemographic information, medical history and physical examination, and blood samples were also collected for hematological, cytogenetic and molecular tests. Descriptive statistics were used to analyze the sociodemographic, hematological, clinical, cytogenetic and molecular profiles of the study participants.

A total of 251 confirmed new CML patients were recruited for the study. The majority of patients were male (151 [60.2%]; chronic (CP) CML, 213 [84.7%]; and had a median age of 36 years. The median (IQR) WBC, RBC, HGB and PLT counts were 217.7 (155.62–307.4) x10 3 /µL, 3.2 (2.72–3.6) x10 6 /µL, 9.3 (8.2–11) g/dl and 324 (211–499) x 10 3 /µL, respectively. All patients had leukocytosis, and 92.8%, 95.6% and 99.2% of the patients developed anemia, hyperleukocytosis and neutrophilia, respectively. Fatigue, abdominal pain, splenomegaly and weight loss were the common signs and symptoms observed among CML patients. Approximately 86.1% of the study participants were Philadelphia chromosome positive (Ph+) according to fluorescence in situ hybridization (FISH). P210, the major breakpoint protein, transcript was detected by both qualitative polymerase chain reaction (PCR) and quantitative real time polymerase chain reaction (PCR).

During presentation, most CML patients presented with hyperleukocytosis, neutrophilia and anemia at TASH, Addis Ababa. Fatigue, abdominal pain, splenomegaly and weight loss were the most common signs and symptoms observed in the CML patients. Most CML patients were diagnosed by FISH, and p120 was detected in all CML patients diagnosed by PCR. The majority of CML patients arrive at referral center with advanced signs and symptoms, so better to decentralize the service to peripheral health facilities.

Peer Review reports

Chronic myeloid leukemia (CML) is a hematopoietic stem cell (HSC)-derived myeloproliferative disorder caused by chromosomal translocation (9; 22). The formation of the Philadelphia (Ph) chromosome and the expression of the breakpoint cluster region (BCR)-Abelson murine leukemia viral oncogene homolog 1 (ABL) fusion gene result from the fusion of a portion of the BCR on chromosome 22 with the ABL tyrosine kinase on chromosome 9 [ 1 , 2 ]. Cytogenetic evidence of the Philadelphia (Ph) chromosome, a reciprocal translocation between the long arm of chromosome 22 at the BCR gene and chromosome 9 at the ABL gene, can be found in more than 95% of CML patients (9;22). As a result, a BCR-ABL fusion gene is formed, resulting in the production of a chimeric protein with constitutively active tyrosine kinase activity [ 2 , 3 , 4 , 5 ].

CML is characterized by anemia, thrombocytosis, and left-shifted leukocytosis [ 6 ]. Most cases of CML can be diagnosed using peripheral blood findings combined with molecular genetic techniques that detect t(9; 22) (q34.1; q11.2) or, more specifically, BCR::ABL1. A bone marrow aspirate, on the other hand, is required to ensure sufficient material for a complete karyotype and for morphologic evaluation to confirm the disease phase [ 7 ]. Patients in the chronic phase of CML have less than 10% blasts in their bone marrow samples [ 8 ]. The accelerated phase of CML is distinguished by bone marrow samples containing 10–20% blasts. The CML blast crisis phase has the same picture as acute leukemia; this stage contains more than 20% blasts, and large clusters of blasts are observed in the bone marrow and spread to tissues and organs other than the bone marrow [ 8 , 9 ].

Molecular tests such as PCR and FISH for t(9;22) (q34;q11.2), which demonstrate BCR-ABLs, are essential for the diagnosis and confirmation of CML [ 10 , 11 ]. The goals of treatment for chronic phase CML are to avoid progression to other advanced stages and to avoid adverse events (AEs) to restore and maintain quality of life so that patients can achieve a life expectancy comparable with that of the general population [ 12 ]. Hydroxyurea (HU) is an S-phase agent that acts by inhibiting DNA synthesis. This drug acts as an inhibitor of ribonucleotide reductase and can lower blood counts within 1 to 2 days, especially if higher than standard doses are used [ 13 ]. Tyrosine kinase inhibitors (TKIs) are potent drugs that significantly improve long-term outcomes in patients with CML [ 14 ].

In the developed world, early diagnosis at an average age of approximately 65 years is common, and most cases are chronic. In contrast, in low-income countries, CML is more commonly diagnosed in the advanced stage and in the younger age group (39 years) [ 3 ]. Early diagnosis and treatment of CML are highly important for preventing and controlling CML as its diagnosis and treatment delay worsen because the disease may progress to clonal mutation and the development of resistance to TKI therapy [ 13 ]. Besides, in low-income countries there is insufficient evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients. Ethiopia is among the low-income and resource-constrained countries where there is limited evidence on the status of new CML patients. Thus, the aim of this study was to determine the hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients during their first presentation at TASH, Addis Ababa, Ethiopia.

Methodology

The study was conducted at TASH hematology clinics, a tertiary care center affiliated with the College of Health Sciences, Addis Ababa University (AAU). TASH was the largest referral hospital in Ethiopia. Patients with CML from all around the country were sent to this institution to be enrolled in the Glivec International Patient Assistance Program and receive treatment (GIPAP).

A cross-sectional study was conducted among confirmed chronic myeloid leukemia patients who were first diagnosed at TASH between August 2021 and December 2022. The study population included CML patients who were diagnosed and confirmed by Xpert BCR-ABL Ultra, FISH and RT‒PCR as CML patients for the first time at TASH hematology clinics. Excluded patients included those with suspected CML who were BCR-ABL, FISH and RT‒PCR negative and confirmed to be CML negative; patients who did not voluntarily provide blood samples; and patients who were extremely ill and unable to provide consent and samples.

A convenient sampling technique was used for all the newly diagnosed patients enrolled during the study period. All CML patients diagnosed between August 2021 and December 2022 were included consecutively to determine the hematological, clinical, cytogenetic and molecular profiles. Accordingly, 251 CML patients were recruited for the study.

Sample collection and laboratory analysis

Blood samples with a volume of 5 mL were collected in an EDTA test tube from all study participants by a certified laboratory expert. Hematological analysis was performed using a Unicel DxH800 at TASH according to the SOPs within a maximum of 8 h following collection. The CBC was analyzed with a Beckman Coulter DxH 800 automated hematology analyzer based on the manufacturer’s recommendations.

For molecular profiles, one of the results used for confirming CML was the Xpert BCR-ABL Ultra test. In vitro diagnostic tests for the quantitation of BCR::ABL1 and ABL1 mRNA transcripts in peripheral blood specimens from patients diagnosed with t(9;22)-positive CML expressing the BCR-ABLl fusion transcripts type e13a2 and/or e14a2 have been performed. The test utilizes automated, quantitative, RT‒qPCR, but it could not differentiate e13a2 from e14a2. The Xpert BCR-ABL Ultra test is intended to measure BCR::ABL1-to-ABL1% ratios on the International Scale (IS).

The other test used for the study was the FISH technique for the initial screening of CML patients via both bone marrow and peripheral blood. The RT‒PCR results were also consistent with the results of other tests we used for the present study, and these results constitute the gold standard for diagnosing and monitoring BCR::ABL1 transcript mRNA in CML patients. All FISH, qualitative and quantitative RT‒PCR were performed abroad in India for all patients.

Quality assurance

The overall activities of data collection were monitored by the principal investigator to maintain the validity of the data during data collection. There was strict supervision during the data collection, and the collected data were checked for completeness, accuracy, clarity, and consistency by the supervisors on a daily basis and by the principal investigator. The samples were verified for hemolysis, clotting, volume, collection time, and proper labeling before proceeding to the analytical procedure. The manufacturer’s procedures, as well as safety precautions and specimen handling procedures, were strictly followed.

The analysis was performed by a senior laboratory technologist. Standard operating procedures were used for specimen processing to maintain good quality. The performance of the automated hematology analyzer was checked by running three levels of hematological cell controls (normal, low and high). The results of complete blood counts were registered as the exact number (value) in a standardized recording format. All laboratory assays were carried out following standard operating procedures (SOPs) by trained and experienced medical technologists.

The data collected were cleaned, checked for completeness and entered in Excel spreadsheet. The data were subsequently exported to the Statistical Package for Social Sciences (SPSS) version 26. The data were analyzed using SPSS. Descriptive statistics were used to analyze the sociodemographic, hematological, clinical, cytogenetic and molecular profiles of the study participants. The distribution of the data was checked, and the median and IQR were used for non-normally distributed data.

Operational definitions

Hgb value < 13 g/dl for males and < 12 g/dl for females. Severe anemia ≤ 7 g/dl, moderate anemia 7.01–10 g/dl, mild anemia 10.01–12 g/dl for females and 10.01–13 g/dl for males.

when a basophil count > 300 cells/µL is found in blood.

Clinical profile

Signs and symptoms of CML patients during presentation.

Confirmed new CML patient

Xpert BCR-ABL Ultra or FISH- or RT‒PCR-positive patients confirmed for the first time as CML patients at TASH hematology clinics.

Eosinophilia

when the eosinophil count is > 500 cells/µL in blood.

Hyperleukocytosis was defined as a WBC greater than 100,000/µL found in blood.

Neutrophilia was defined as a higher neutrophil count (> 7.9 × 103/µL). Prechemotherapy naive if the patients never received HU treatment

Pre chemotherapy treated Patients who had received HU treatment

Splenomegaly

Spleen swelling of the categorized size; massive splenomegaly > 10 cm, moderate 4–9 cm and mild size of 1–3 cm.

Thrombocytopenia

a PLT < 150 × 10 3 cells/µL found in blood.

Thrombocytosis

a PLT > 450 × 10 3 cells/µL found in blood.

Sociodemographic characteristics of the study participants

A total of 251 CML patients were diagnosed and included in the study. Among the total study participants, 107 and 144 were naïve and HU-treated, respectively. More than half (60.2%, 151) of the patients were males. The median age of the study participants was 36 (IQR (29–47) years, and more than 91% of the study participants were ≤  60 years old. More than 51% and 44% came from rural area and travelled more than 300KM distance to reach the TASH, respectively. The median for duration with symptoms of our study participant was five months (Table  1 ). And the time it takes from initial diagnosis to confirmation was approximately two weeks since most of the patients should send the sample to abroad for confirmation.

Hematological profile of the study participants

The median (IQR) WBC count was 217.7 (155.62–307.4) ×10 3 /µL, which was determined for patients who were both naïve and treated with HU during presentation. The median (IQR) WBC counts for patients who were naïve and treated with HU were 261.2 (186.6-349.7) × 10 3 /µL and 188.3 (139.3-290.73) ×10 3 /µl, respectively, during presentation. For the absolute neutrophil count (ANC), the overall median (IQR) was 174.8 (111.3-263.6) x10 3 /µL, whereas for patients naive and treated with HU, the median (IQR) was 201 (137.12–295.6) x10 3 /µL and 145.25 (97.2-241.57) x10 3 /µL, respectively.

For RBC parameters, the median (IQR) value for RBC was 3.2 (2.72–3.6) x10 6 /µL. The median (IQR) RBC counts for patients who were naïve to treatment and those treated with HU were 3.05 (2.7–3.6) ×10 6 /µL and 3.3 (2.72–3.75) ×10 6 /µL, respectively. With respect to the PLT, the median (IQR) value was 324 (211–499) x10 3 /µL. The median (interquartilerange (IQR)) PLTs for patients naïve and treated with HU were 322 (211–447) ×10 3 /µL and 324.5 (211-508.75) ×10 3 /µL, respectively. There were significant differences in hematological parameters, such as the WBC count ( P  < 0.001 ), HGB count ( P  = 0.024 ), and HCT count ( P  = 0.024 ), between naive and HU treated groups (Table  2 ).

Common hematological abnormalities among new CML patients

All patients had leukocytosis, and greater than 95.6% of the patients had hyperleukocytosis. Among the study participants, 233 (92.8%) CML patients developed anemia, and moderate anemia was common among 136 (54.2%) CML patients, followed by mild anemia 76 (30.3%) and severe anemia 21 (8.4%) during presentation. The percentages of CML patients with eosinophilia and basophilia were 96.5% and 88.5%, respectively. However, the medians (IQRs) for eosinophils and basophils were 2.3 (1.4–3.85)% and 1.1 (0.3–3.3)%, respectively, of the total WBC count (Table  3 ).

Distribution of common hematological abnormalities among patients in the CML phases

Among the 91 HUnaïve and 122 HUtreated CP CML patients, 90 (98.9%) and 113 (92.6%) had hyperleukocytosis, respectively. Most CP-phase WBCs fell in the range of 100–250 × 10 3 /µL, whereas 33 (15.5%) CP and 10 (33.3%) AP patients had  ≥  351 × 10 3 /µL WBC counts. In the AP CML phase, 29 (96.7%) patients had hyperleukocytosis, whereas all eight BC CML patients had hyperleukocytosis. Among the 91 HUnaïve and 121 HUtreated CP CML patients, 58 (63.7%) and 55 (45.1%) had moderate anemia, respectively. Among the phases, 89.2% and 90% of the CPs and APs, respectively, developed anemia, whereas only one BC CML patient treated with HU was free from anemia. Regarding the PLT, of the 91 HUnaïve and 121 HUtreated CP CML patients, 54 (59.3%) and 70 (57.4%) had normal PLTs, respectively. Furthermore, thrombocytopenia was observed in 27 (12.7%), 3 (10%) and 4 (50%) patients in the CP, AP and BC CML phases, respectively. Thrombocytosis was observed in 62 (29.1%) patients with CP, 10 (32.2%) with AP and one patient in the BC CML phase. For the neutrophilic distribution, except for one patient in the CP CML phase, there was neutrophilia in all phases of CML.

Clinical profile of the study participants

Among 251 study participants, 213 (84.7%) were at the CP stage, 30 (12%) were at the AP stage, and 8 (3.2%) were at the BC stage. The majority of CML patients were symptomatic at the time of presentation; the most common symptoms were fatigue (242; 96.4%), abdominal pain (231; 92%), splenomegaly (232; 92.4%) and weight loss (221; 88%) (Fig.  1 ). The prognostic risk scores of all the study participant were calculated (Table  4 ).

figure 1

Clinical profile of confirmed CML patients at presentation

Splenomegaly is one of the main symptoms of patients. A massive, moderate or mild increase in spleen size was indicated. Among the 232 study participants who had splenomegaly, 62.9% had massive splenomegaly with a spleen size > 10 cm, 34.9% had moderate splenomegaly with a spleen size of 4–9 cm, and 2.1% had mild splenomegaly with a spleen size of 1–3 cm. Approximately  85% of CPs had splenomegaly, whereas only one AP and one BP CML patient were free from splenomegaly.

Cytogenetic and molecular profiles

All of the study participants were positive for the Philadelphia chromosome or BCR::ABL1, and the p210 BCR::ABL1 fusion transcript was detected. After cytogenetic analysis of 251 confirmed CML patients, FISH was performed for 222 (88.5%) CML patients; 216 (97.3%) were Philadelphia chromosome positive (Ph+), whereas in six patients Philadelphia was absent or negative. The median (IQR) number of Ph + cells per 100 cells was 95% (85–100%) among the study participants diagnosed and positive by FISH. Among the Ph + cases, the distributions of CML phases were 85.6%, 11.6% and 2.8% for CP, AP and BC, respectively. Except for one AP patient, all the other Ph-negative patients were CP CML patients.

The remaining 35 (13.9%) patients were diagnosed by the Xpert BCR-ABL Ultra test (GeneXpert, Cepheid) (twety three) ( 23 ) and by quantitative (six) and qualitative (six PCR. In our study area, for new patients, the Xpert BCR-ABL Ultra test (RT‒PCR) was performed for patients who cannot afford FISH (which is performed abroad). The Xpert BCR-ABL Ultra test results showed that 20 (87%) of the new CML patients had > 55% (above the upper LoQ), which indicated that BCR::ABL1 L fusion was detected at a level > 55% (IS). Qualitative PCR was performed for six patients who were FISH negative, and p210 (BCR/ABL), the major breakpoint protein, transcript was detected. Among the transcripts identified by both quantitative and qualitative PCR, all the detected transcripts were of the major breakpoint protein, p210 (BCR/ABL), which is frequently encoded by the e13a2/e14a2 isoforms.

CML is characterized by anemia, thrombocytosis, and leukocytosis with a shift to the left. Molecular tests such as PCR and FISH for t(9;22) (q34;q11.2), which demonstrate BCR-ABLs, are essential for the diagnosis and confirmation of CML [ 10 , 11 ]. However, the data related to hematological, clinical, cytogenetic and molecular profiles of CML patients is very limited in low-income countries as a result we motivated to describe these profiles among CML patients during presentation.

The median age was 36 years, and more than 91% of the study participants were ≤  60 years old. This finding is consistent with the study conducted by Mulu Fentie A et al., which reported a total of 27.2% of patients aged 31–40 years [ 15 ]. These findings are comparable with those of the studies conducted by Tadesse F et al., in which the median age was 33 years [ 3 ], and by Ngono AP et al., in which the mean age was 39.2 years [ 1 ]. This shows that younger populations were affected by CML. In this study, males (60.2%) were more affected by CML than females were, with a ratio of 1.5:1. This finding is also similar to that of a study conducted in Pakistan, in which the male-to-female ratio was 1.6:1 [ 16 , 17 ]. This finding is also similar to that of a study conducted in Iraq in which 57.1% of the participants were male (Al-abady I et al., 2021) [ 18 ]. These findings may support the finding that CML affects younger individuals aged 39 years in low-income countries [ 3 ], although the reason why younger individuals are affected by CML is not clear in developing countries.

Among 251 study participants, 213 (84.8%) were in the CP, 30 (12%) were in the AP and 8 (3.2%) were in the BC. These findings are similar to those of Kumar S et al., who reported that 83% of CML‑CP, 12% of AP, and 5% of AP patients were in the BC phase in India [ 19 ]. Furthermore, a study from India by Srinivas KG et al. reported comparable findings: CP (90.1%), AP (4.5%) and BC (5.4%) [ 20 ]. However, our findings were inconsistent with those of Ngono AP et al. in Cameroon, especially for CP-CML (66%) [ 1 ], and with those of Sinha R. et al. [ 21 ] in India. Sinha et al. reported that 28.1% of patients were in the AP phase, which is higher than our finding (12.1%). Similarly, there were fewer findings in the BC phase than in Cameron, 22.7% of which were reported by Ngono AP et al. and 7.8% by Sinha R et al. in India [ 1 , 21 ]. This difference could be due to the difference in sample size since the sample sizes for both patients were much smaller than our sample size and because of the difference in duration of symptoms. Furthermore, advanced-stage CML was prevalent, possibly because patients were diagnosed at advanced stages because of late detection, the lack of facilities available to detect CML at peripheral health facilities and poor culture available to visit health facilities for health checks.

The median (IQR) WBC count was 217.7 (155.62–307.4) ×10 3 /µL, and all patients had leucocytosis, whereas 95.6% had hyperleukocytosis. This finding is similar to that of the study conducted by Tadesse F et al., which revealed that all the patients had leukocytosis [ 3 ]. Similarly, in a study conducted in Iraq by Al-abady I et al., the mean WBC count was 153.7 × 10 9 /L, ranging from 29 to 436 × 109/L. Furthermore, in a study performed in Tanzania by Henke O et al., the median WBC was 300.5 × 10 9 /L (78–499 × 10 9 /L) [ 22 ]. This finding was also consistent with those of studies conducted by Ngono AP et al., Kumar et al. and Wiyono et al. [ 1 , 6 , 19 ]. Leukocytosis is expected in CML patients, but as most of the study participants had hyperleukocytosis, this could make diagnosis difficult because the patients need to come to TASH frequently and be forced to take HU for a longer time as the WBC count decreases to the recommended number (20–30 × 10 9 /L and clinical parameters also considered) to start chemotherapy. This could also explain why CML patients dropped out before starting chemotherapy (imatinib, a first generation TKI) in our study area.

For the absolute neutrophil count (ANC), the median (IQR) value was 174.8 (111.3-263.6) x10 3 /µL during presentation. Patients who were naïve to treatment or treated with HU had 201 (137.12–295.6) x10 3 /µL and 145.25 (97.2-241.57) x10 3 /µL ANC, respectively. Our study showed that almost all (99.2%) of the participants had neutrophilia, which is in line with the results reported from Tanzania by Tebuka E et al. (ANC 179(± 123) K/µL) [ 22 ]. In addition, our study revealed that 88.5% of the study participants had basophilia, although the relative percentage median (IQR) was 1.1 (0.3–3.3)%, which is comparable with the findings of Al-abady et al. [ 18 ]. . Neutrophils are among the WBC components that are expected to increase in CML patients; as a result, neutrophilia was observed in almost all the study participants. In addition, basophil formation is usually observed in CML patients; as a result, basophilia was also prevalent, although the relative percentage is dominated by neutrophils. However, neutrophilia and basophilia were also observed among patients treated with HU because either the patients took HU for short days or they took a low dose during presentation.

For Hgb, the median (IQR) value was 9.3 (8.2–11) g/dl. The median (IQR) values for patients who were naïve to treatment and treated with HU were 8.9 (7.9–10.2) g/dl and 9.75 (8.33–11.2) g/dl, respectively. Approximately 19(7.4%) had severe, 138(53.9%) moderate and 78(30.4%) mild anemia which was comparable with study conducted by Tadesse F et al. that reported 96.7% of CML patients had anemia [ 3 ]. These findings are also similar to those of a study by Kumar S et al., in which 13% had severe anemia, 58.8% had moderate anemia and 28.2% had mild anemia [ 19 ], and those of Ngono AP et al., in which 86.4%, 61.4% and 5.3% had moderate, respectively [ 1 ]. Furthermore, a study conducted by Chang F et al. revealed that 95.1% of patients developed anemia and mild anemia (22.8%) and moderate anemia (46.9%), but these proportions differed for severe anemia (30.1%) [ 16 ]. The difference may be due to sample size, duration of symptoms and geographical location. As expected, the incidence of anemia was high, and moderate anemia was the dominant anemia among the study participants; this was also related to the clinical stage at which the patients came to our study site, TASH.

With respect to the PLT, the median (IQR) value was 324 (211–499) x10 3 /µL during presentation. The medians (IQRs) of the PLTs for patients’ naïve to treatment with HU were 322 (211–447) ×10 3 /µL and 324.5 (211-508.75) ×10 3 /µL. Approximately 73 (29.1%) and 34 (13.5%) patients had thrombocytosis and thrombocytopenia, respectively. These findings were consistent with those of the study conducted by Ngono AP et al., which reported that a normal PLT was found in 80 (60.6%) patients, 11 (8.3%) had thrombocytopenia, and 41 (31.1%) had thrombocytosis [ 1 ]. In addition, our findings were comparable with those of a study conducted by Tadesse et al., which revealed that 23.3% of the study participants had thrombocytosis [ 3 ], however, there is some variation, which could be due to sample size differences or variations since our sample size was larger than those in those studies. In addition, this was an indication of the variation in the PLT among CML patients, which could be normal in some cases but thrombocytosis in others.

The duration of symptoms in our study participants (median (IQR)) was 5 (2.25-12) months, with a range from 0 to 60 months. These results were comparable with the results reported from Tanzania by Tebuka E et al., in which the duration of symptoms was 15 (± 9) months, ranging from 0 to 48 months [ 23 ]. All CML patients in this study were symptomatic at the time of presentation, and the common complaint was fatigue (96.4%), followed by abdominal pain (92%), splenomegaly (89.2%), weight loss (88%) and abdominal swelling (80.5%). These findings are in line with the findings of studies conducted by Sultan S et al., Al-abady I et al. and Sinha R [ 17 , 18 , 21 ]. This percentage was greater than that in the study by Srinivas KG et al. ., which revealed that the common presentations were fatigue (60%), fever (48%), weight loss (37%) and splenomegaly (20%). Another Indian study revealed that fullness in the abdomen was 66.6%, fever was 59%, and fatigue was 55.5% [ 19 ]; these findings can be attributed to differences in sample sizes among studies, environmental factors and durations of symptoms.

Splenomegaly (92.4%) presented in different categorical sizes in this study; 146 (62.9%) patients had massive splenomegaly, 81 (34.9%) developed moderate splenomegaly, and 5 (2.1%) had mild splenomegaly. These findings are comparable with the study performed by Tadese F et al., whose overall range was 3–26 cm [ 3 ] since most of the findings in our study indicated moderate and massive splenomegaly. Additionally, the prevalence of splenomegaly was comparable to that in a study performed in Pakistan [ 17 ], in which the prevalence was 89.3%. Furthermore, these findings are consistent with those of a study from India [ 19 ], which reported incidences of 62%, 22.2% and 15.6% for massive, moderate and mild, respectively. The difference in moderate and mild symptoms may be due to the duration of symptoms among the study participants, and the sample size could be the reason since our sample size was larger than that of their study participants.

Of the 251 confirmed CML patients, approximately 86.1% were confirmed by FISH and were Ph+ (t (9; 22) positive). Approximately 9.2% and 4.8% of the patients were confirmed by the Xpert BCR-ABL Ultra test and PCR, respectively, which indicated that these patients were BCR::ABL1  or p210-positive. These molecular testing methods were also used in other studies; for example, Ngono AP et al. , from Cameroon, used (22.7%) FISH and (4.5%) RT‒PCR and detected the presence of the t(9; 22) or BCR::ABL1 transcript in all patients [ 1 ]. According to the CML data obtained by both quantitative and qualitative PCR, all the detected transcripts were of major breakpoint proteins, and p210 is encoded by the e13a2/e14a2 isoform. The presence of the BCR::ABL1 transcript as a result of reciprocal translocation between chromosomes 9 and 22 is well known in CML. In more than 95% of CML patients, the typical BCR::ABL1 transcript subtypes are e13a2 (b2a2), e14a2 (b3a2), or the simultaneous expression of both) [ 24 , 25 ].

In our case, qualitative PCR was performed for FISH negative patients; accordingly, six patients who were FISH negative were P210-positive according to qualitative PCR. Qualitative PCR is appropriate for the initial diagnosis of CML, and it can detect the presence of the p210, p190 and p230 transcripts. Thus, although there is an unaffordability of different advanced molecular techniques among suspected CML patients, using these different molecular techniques is important for providing accurate diagnosis and early detection and for monitoring CML patients.

Strengths and limitations

This study included relatively large sample sizes and was conducted at the only CML clinic in the country; thus, it could represent the country of interest, Ethiopia. Since this was the first study conducted on this topic, it provides current information on the hematological, clinical, cytogenetic and molecular profiles of newly diagnosed CML patients. As a limitation, further testing was not performed, as was clinical chemistry. In addition, for every patient, cytogenetic and molecular analyses were not performed due to the unavailability and unaffordability of these tests since they were performed abroad.

During presentation, most of the CML patients had hyperleukocytosis, neutrophilia or anemia at TASH, Addis Ababa, Ethiopia. Patients in younger age groups with a median age of 36 years and more than 91% ≤ 60 years were affected by CML in Ethiopia. Approximately 85% of the CML patients had CP-CML, whereas more than 42.6% of the patients had abnormal platelet counts. Fatigue, abdominal pain, splenomegaly and weight loss were the most common signs and symptoms observed in the CML patients. Most of the study participants were Ph + according to FISH analysis, and the major breakpoint protein p210, which is encoded by the e13a2/e14a2 transcript, was detected in all patients diagnosed by both quantitative and qualitative PCR.

Most of the patients come from distant areas; as a result, they arrive after advanced stages with different signs and symptoms, thus better to decentralize the service to peripheral health facilities. In addition, a locally established reference range for hematological and clinical parameters should be established considering age, sex, geographical location and other variables, as well as access to advanced laboratory facilities for early detection and monitoring of cytogenetic and molecular parameters of CML patients.

Data availability

The datasets generated and/or analyzed during the current study are not publicly available due [we do not have consent from all patients and ethical approval committees to publish this data] but are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to acknowledge Addis Ababa University for giving us the chance to conduct the study through thematic research. In addition, we would like to extend our respect and acknowledgment to the study participants and CML clinic staff members especially for Sr Birhane Gebre, Yemeserach Dessie and Mr Lenjisa Kumsa for helping us during data collection period.

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Medical Laboratory Sciences Department, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Fekadu Urgessa, Boki Lengiso & Aster Tsegaye

Internal Medicine Department, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Amha Gebremedhin, Fozia Abdella & Fisihatsion Tadesse

Cellular and Molecular Biology Department, College of Natural and Computational Sciences, Addis Ababa University, Addis, Ababa, Ethiopia

Fekadu Urgessa, Helen Nigussie & Teklu Kuru Gerbaba

Fred Hutchison Cancer Center, Seattle, WA, USA

Jerald Radich

Microbix Biosystems Inc, Mississauga, ON, Canada

Teklu Kuru Gerbaba

Ethiopian Public Health Institute, Addis Ababa, Ethiopia

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Contributions

FU and BL conducted the literature search, collected and analyzed the data, and wrote the manuscript. FU and BL were also participated in the writing, analysis and data interpretation, in addition to providing critical input to the research. All authors conceptualized and designed the study. AT, AG, FA, FT, TR, HN and TKG supervised the data collection, participated in data analysis, contributed to the discussion, reviewed and edited the manuscript, and provided critical data interpretation. All authors read and accepted the final manuscript.

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Correspondence to Fekadu Urgessa .

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Ethics approval and consent to participate.

The study was approved by the Department of Medical Laboratory Sciences, College of Health Science, AAU ethical committee, and permission was granted from the Department of Internal Medicine, TASH, AAU. Written informed consent was obtained from the patients, care givers or parents. The confidentiality of the participant data was linked to the study code number, and the data were kept private. Any abnormal test results of the study participants were communicated to their attending physician.

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We, the authors declare that there is no conflict of interest.

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Urgessa, F., Lengiso, B., Tsegaye, A. et al. Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a tertiary care teaching hospital in Addis Ababa, Ethiopia: a cross-sectional study. BMC Cancer 24 , 530 (2024). https://doi.org/10.1186/s12885-024-12282-x

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Received : 23 January 2024

Accepted : 17 April 2024

Published : 26 April 2024

DOI : https://doi.org/10.1186/s12885-024-12282-x

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Historical Figures and Leaders - History - 1st Grade

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