Abstract
Introduction: Chronic lymphocytic leukemia (CLL) is marked by the presence of mature lymphocytes that display B cell markers. The disease primarily affects older adults, typically those between 65 and 72 years old, while people under 30 represent only about 2% of all CLL cases.
Case Illustration: A young indigenous male in his twenties from a remote area in South Papua presented with a year-long history of generalized weakness. He described recent onset of easy fatigue, two weeks of melena with intermittent abdominal pain, and a 10-day history of nosebleeds and coughing. On examination, he was pale and had widespread lymph node enlargement, bilateral lung rhonchi, as well as an enlarged liver and spleen. Blood tests revealed severe anemia (hemoglobin 2.5 g/dL), a markedly elevated white blood cell count (284 × 10³/µL), and a significantly reduced platelet count (15 × 10³/µL). Peripheral blood smear showed numerous smudge cells. He received supportive care, including multiple blood transfusions and symptomatic management, with clinical improvement before discharge and planned regular follow-up
Discussion: This case highlights an uncommon occurrence of suspected CLL in a young Indigenous male from South Papua, a population rarely associated with this condition. Given CLL’s strong age-related predisposition, his presentation underscores the need to consider atypical demographics in differential diagnoses, particularly in resource-limited settings where delayed detection may worsen outcomes. The case enriches sparse data on early-onset CLL and emphasizes the importance of heightened clinical suspicion, even in younger patients with nonspecific hematologic abnormalities.

Key words: Suspected Chronic Lymphocytic Leukemia, Early-Onset Leukemia, Young Adult, Indigenous Population, Papua, Resource-Limited Setting