| الوصف: |
Background: The objective was to investigate the factors influencing survival of Nigerians with Myelomatosis. Materials and Methods: The pre-therapy clinical and laboratory features of patients managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, between June 1986 and May 2001 were studied. Diagnosis was based on history of bone pain, marrow plasmacytosis, osteolytic bone lesions, serum biochemical profile, monoclonal (M) band, and/or Bence-Jones proteinuria. Results: Twenty-seven patients (22 males, 5 females) aged 15 to 81 (median, 60) years were managed within the study period. Of the 27, 5 (18.5%) were 40 years or younger while 14(51.8%) were 60 years or older. Multiple myeloma (MM) is the main sub-type seen (81.5%). Majority presented with bone pain, weakness, fatigue and inability to walk. Anaemia, high erythrocyte sedimentation rate and bone marrow plasmacytosis were the significant haematological findings. Serum protein electrophoresis showed M-band in 6 cases of MM, with 3 of them also having Bence-Jones proteinuria. Renal function impairment and hypercalcaemia occurred mainly in those with MM. Multiple osteolytic lesions and pathological fractures were recorded in 44% of those with MM and Solitary Myeloma of Bone. Twelve patients were already dead at the time of analysis, with renal failure being the cause in 8 and anaemia in the rest. The median survival was 1.2 months. Conclusions: We could conclude that the presenting features of Nigerian patients with myelomatosis are not different from reports elsewhere, but high default rate and short survival are particularly noted. Key words: Myelomatosis, Clinical features, Survival, Nigerians. Resume Introduction: L'objectif etait d'etudier les facteurs qui influencent la survivie des Nigerians atteints de la myolomatose. Materiels et Methodes: Les traits laboratoires et pre-therapie cliniques des patients soignes au centre hospitalier universitaire d'Obafemi Awolowo, Ile-Ife entre juin 1986 et 2001 ont ete etudies. Le diagnostic etait fonde sur l'histoire de la douleur osseuse, des plasmocytes dans les moelle osseuse, lesions osteolytique osseuses, serum de profile biochimique, monoclonal (M) groupe et/ou proteinurie Bence-Jones. Resultats: Vingt sept patients (22 du sexe masculin, 5 du sexe feminin) âges 15 a 81 (moyen 60) ans ont ete soignes au cours de la duree de cette etude. Entre 27,5 (18,5%) nous avions 40 ans ou moins tandis que 14 soit (51,8%) nous avions 60 ans ou âge de plus de 60. Myelome Multiple (MM) est principalement le sous-type vu (81,5%). La plus grande partie se sont presentees atteintes de la douleur osseuse, faiblesse, la fatigue, incapacite de marcher. Anemie, taux eleve de la sedimentation erythrocyte et la plasmocytes dans les moelles osseuses etaient notamment les resultats hematologiques. Serum de la proteine electrophorese avait indique M-groupe chez 6 cas de MM, avec 3 d'entre eux egalement atteints de la protenurie Bence-Jones. Affiablessement de la fonction renale, et l'hypercalcemie ont ete provoques surtout chez ceux avec MM. Lesions osteolytiques multiples et des fractures pathologiques ont ete notees chez 44% de ceux avec MM et le myelome solitaire osseux. Douze patients sont deja morts au moment d'analyse, atteints de l'insuffisance renale etant la cause attribuable chez 8 et anemie chez d'autres. La survie moyenne etait 1, 2 mois. Conclusions: De ceci nous conclons que les traits accuses des patients nigerians atteints de myelomatose ne sont pas differents des rapports d'ailleurs, mais on avait particulierement note le taux eleve de defaut et survie breve. West African Journal of Medicine Vol.24(1) 2005: 54-57 |
