Multiple myeloma: a ten year study of survival and therapy in a developing nation.
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
Omoti
Caroline Edijana
CE
Department of Haematology, University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria.
Omuemu
Casmir Edisma
CE
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
D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D011239:Prednisolone; D008558:Melphalan