title: Multiple myeloma: a ten year study of survival and therapy in a developing nation.
abstract: OBJECTIVE
  To analyze the survival related to therapeutic modalities and haematological indices at presentation with outcome performed on records of all multiple myeloma (MM) patients'.
  
  
  METHODS
  A prospective study was conducted in the University of Benin Teaching Hospital, Nigeria from 1993 to 2003. Thirty patients were identified with diagnosis confirmed on the basis of atypical plasmacytosis (=30% in the bone marrow), monoclonal component in the serum or urine and radiological evidence of the typical skeletal lytic lesions.
  
  
  RESULTS
  Males (n = 20) outnumbered the females (n = 10), with a median age of 54 years. The mean duration of survival of all patients was 7 months (median 3 months; P < 0.0001) with only 13.3% of the patients surviving at two years. The mean duration of survival of 10 patients on either therapy of vincristine, adriamycin, dexamethasone (VAD) or 8 patients on melphalan, prednisolone (MP) was 3 months, significantly shorter than 21 months for the 5 patients on a combination of both forms of therapy at different times (COMB) (P = 0.0067). The Kaplan-Meier estimates of survival showed survival probability was least in those without definitive therapy (NONE) as expected.
  
  
  CONCLUSIONS
  Late presentation and inadequate treatment from poor compliance with therapy in a setting of poverty and ignorance are suggested as factors contributing to the poor survival of the patients studied
authors.affiliation: Department of Haematology, University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria.
authors.forename: Caroline Edijana
authors.initials: CE
authors.lastname: Omoti
authors.forename: Casmir Edisma
authors.initials: CE
authors.lastname: Omuemu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D003906:Developing Countries; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality*; D009549:Nigeria / Q000453:epidemiology; D011239:Prednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D011239:Prednisolone; D008558:Melphalan