Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions
Ogbonna Collins Nwabuko,1,2 Elizabeth Eneikido Igbigbi,3 Innocent Ijezie Chukwuonye,4 Martin Anazodo Nnoli5 1Department of Haematology, Federal Medical Center, Umuahia, 2Department of Haematology, College of Health Science, Abia State University, Aba, Abia State, 3Department of Haematology, Blood Tr...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2017-05-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/multiple-myeloma-in-niger-delta-nigeria-complications-and-the-outcome--peer-reviewed-article-CMAR |
| _version_ | 1818681625317212160 |
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| author | Nwabuko OC Igbigbi EE Chukwuonye II Nnoli MA |
| author_facet | Nwabuko OC Igbigbi EE Chukwuonye II Nnoli MA |
| author_sort | Nwabuko OC |
| collection | DOAJ |
| description | Ogbonna Collins Nwabuko,1,2 Elizabeth Eneikido Igbigbi,3 Innocent Ijezie Chukwuonye,4 Martin Anazodo Nnoli5 1Department of Haematology, Federal Medical Center, Umuahia, 2Department of Haematology, College of Health Science, Abia State University, Aba, Abia State, 3Department of Haematology, Blood Transfusion and Immunology, Faculty of Basic Medical Sciences, University of Port Harcourt, Port Harcourt, 4Department of Internal Medicine, Federal Medical Center, Umuahia, 5Department of Anatomic Pathology, University of Calabar, Calabar, Nigeria Background: Multiple myeloma (MM) is one of the hematological malignancies that require palliative care. This is because of the life-threatening nature and the suffering associated with the illness. The aim of this study is to bring to the fore the complications experienced by people living with MM in the Niger-Delta region of Nigeria and the outcome of various palliative interventions.Methods: This was a 10-year multi-center retrospective study of 26 patients diagnosed and managed in three major centers in the Niger-Delta region of Nigeria from January 2003 to December 2012. Information on the clinical, laboratory, radiological data, and palliative treatment was obtained at presentation and subsequently at intervals of 3 months until the patient was lost to follow-up.Result: The mean duration from onset of symptoms to diagnosis was 13.12 months (95% CI, 6.65–19.58). A total of 16 (61.5%), eight (30.8%), and two subjects (7.7%) presented in Durie–Salmon (DS) stages III, II, and I, respectively. The complications presented by patients at diagnoses included bone pain (84.6%), anemia (61.5%), nephropathy (23.1%), and hemiplegia (35%). All the patients received analgesics, while 50.0% received blood transfusion, 56.7% had surgery performed, 19% had hemodialysis, and 3.8% received radiotherapy. A total of 10 (38%) patients benefited from bisphosphonates (BPs). A total of 57.6% of patients were on melphalan–prednisone (MP) double regimen, while 19% and 8% patients were on MP–thalidomide and MP–bortezomib triple regimens, respectively. A total of 3.8% of patients at DS stage IIIB disease had autologous stem-cell transplantation (ASCT). Only 7.6% of the myeloma patients survived up to 5 years post diagnosis. The overall mean survival interval was 39.7 months (95% CI, 32.1–47.2).Conclusion: Late diagnosis and inadequate palliative care account for major complications encountered by MM patients in the Niger-Delta region of Nigeria. This could be responsible for the poor prognostic outcome and low survival interval of MM individuals in this region. There is, therefore, a need to improve the quality of palliative care received by myeloma patients in this region. This is achievable via provision of relevant and affordable health care facilities for diagnosis and treatment of the disease. Keywords: multiple myeloma, palliative care, melphalan-prednisone, bone marrow plasma cells, autologous stem-cell transplantation, Niger Delta |
| first_indexed | 2024-12-17T10:05:55Z |
| format | Article |
| id | doaj.art-65c17b4eb5024dc4a0374b81b4e83e67 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-17T10:05:55Z |
| publishDate | 2017-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-65c17b4eb5024dc4a0374b81b4e83e672022-12-21T21:53:10ZengDove Medical PressCancer Management and Research1179-13222017-05-01Volume 918919632954Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventionsNwabuko OCIgbigbi EEChukwuonye IINnoli MAOgbonna Collins Nwabuko,1,2 Elizabeth Eneikido Igbigbi,3 Innocent Ijezie Chukwuonye,4 Martin Anazodo Nnoli5 1Department of Haematology, Federal Medical Center, Umuahia, 2Department of Haematology, College of Health Science, Abia State University, Aba, Abia State, 3Department of Haematology, Blood Transfusion and Immunology, Faculty of Basic Medical Sciences, University of Port Harcourt, Port Harcourt, 4Department of Internal Medicine, Federal Medical Center, Umuahia, 5Department of Anatomic Pathology, University of Calabar, Calabar, Nigeria Background: Multiple myeloma (MM) is one of the hematological malignancies that require palliative care. This is because of the life-threatening nature and the suffering associated with the illness. The aim of this study is to bring to the fore the complications experienced by people living with MM in the Niger-Delta region of Nigeria and the outcome of various palliative interventions.Methods: This was a 10-year multi-center retrospective study of 26 patients diagnosed and managed in three major centers in the Niger-Delta region of Nigeria from January 2003 to December 2012. Information on the clinical, laboratory, radiological data, and palliative treatment was obtained at presentation and subsequently at intervals of 3 months until the patient was lost to follow-up.Result: The mean duration from onset of symptoms to diagnosis was 13.12 months (95% CI, 6.65–19.58). A total of 16 (61.5%), eight (30.8%), and two subjects (7.7%) presented in Durie–Salmon (DS) stages III, II, and I, respectively. The complications presented by patients at diagnoses included bone pain (84.6%), anemia (61.5%), nephropathy (23.1%), and hemiplegia (35%). All the patients received analgesics, while 50.0% received blood transfusion, 56.7% had surgery performed, 19% had hemodialysis, and 3.8% received radiotherapy. A total of 10 (38%) patients benefited from bisphosphonates (BPs). A total of 57.6% of patients were on melphalan–prednisone (MP) double regimen, while 19% and 8% patients were on MP–thalidomide and MP–bortezomib triple regimens, respectively. A total of 3.8% of patients at DS stage IIIB disease had autologous stem-cell transplantation (ASCT). Only 7.6% of the myeloma patients survived up to 5 years post diagnosis. The overall mean survival interval was 39.7 months (95% CI, 32.1–47.2).Conclusion: Late diagnosis and inadequate palliative care account for major complications encountered by MM patients in the Niger-Delta region of Nigeria. This could be responsible for the poor prognostic outcome and low survival interval of MM individuals in this region. There is, therefore, a need to improve the quality of palliative care received by myeloma patients in this region. This is achievable via provision of relevant and affordable health care facilities for diagnosis and treatment of the disease. Keywords: multiple myeloma, palliative care, melphalan-prednisone, bone marrow plasma cells, autologous stem-cell transplantation, Niger Deltahttps://www.dovepress.com/multiple-myeloma-in-niger-delta-nigeria-complications-and-the-outcome--peer-reviewed-article-CMARMultiple Myeloma (MM)Palliative careMelphalan-Prednisone (MP)Bone Marrrow Plasma Cells (BMPC)Autologous Stem Cell Transplantation (ASCT). |
| spellingShingle | Nwabuko OC Igbigbi EE Chukwuonye II Nnoli MA Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions Cancer Management and Research Multiple Myeloma (MM) Palliative care Melphalan-Prednisone (MP) Bone Marrrow Plasma Cells (BMPC) Autologous Stem Cell Transplantation (ASCT). |
| title | Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions |
| title_full | Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions |
| title_fullStr | Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions |
| title_full_unstemmed | Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions |
| title_short | Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions |
| title_sort | multiple myeloma in niger delta nigeria complications and the outcome of palliative interventions |
| topic | Multiple Myeloma (MM) Palliative care Melphalan-Prednisone (MP) Bone Marrrow Plasma Cells (BMPC) Autologous Stem Cell Transplantation (ASCT). |
| url | https://www.dovepress.com/multiple-myeloma-in-niger-delta-nigeria-complications-and-the-outcome--peer-reviewed-article-CMAR |
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