title: Multiple myeloma in Nigeria: a multi-centre epidemiological and biomedical study.
abstract: BACKGROUND
  Myelomatosis is a malignant proliferation of plasma cells in the bone marrow, with relatively high prevalence in African populations. Variation in genetic mutations has been observed in individual patients and may be responsible for differences in disease pattern and treatment outcomes. This study described the presentations and treatment outcomes of multiple myeloma in nigerian.
  
  
  METHODS
  The data was obtained retrospectively from the case notes of 135 patients diagnosed with multiple myeloma from eight tertiary health institutions across the six geopolitical zones of Nigeria from 2005 to 2014. Data analysis was carried out using SPSS 17.0.
  
  
  RESULTS
  The predominant presentations were bone pain in 97 (74%), nephropathy in 47 (35.9%) and pathological fractures in 58 (44.3%). Sixty-seven percent (67%) of the patients were less than 60 years, and 35% had Bence Jones proteinuria. The overall survival beyond 6 months was 91.3%, mean duration of survival rate was 7.4 months. Majority (66.2%) were on Melphalan alone or on melphalan-containing combinations. A higher packed cell volume (PCV) and total serum protein levels at presentation were associated with increased survival, p=0.033 and 0.036, respectively.
  
  
  CONCLUSIONS
  This study portrayed the importance of detail investigation on the causes of bone pain and anaemia in person's aged 40 years and above. There is a high prevalence of nephropathy in this cohort of patients which needs to be further investigated. Majority of the patients, though < 65 years of age were placed on melphalan-containing combinations, which foreclosed chances of future autologous bone marrow transplantation.
authors.affiliation: Clinical Sciences Division, Nigerian Institute of Medical Research Lagos Nigeria.
authors.forename: Odunukwe Nkiruka
authors.initials: ON
authors.lastname: Nnonyelum
authors.affiliation: Department of Haematology and Blood Transfusion, University of Nigeria Teaching Hospital Enugu, Nigeria.
authors.forename: Madu Jude
authors.initials: MJ
authors.lastname: Anazoeze
authors.affiliation: Department of Haematology College of Health Sciences University of Abuja teaching Hospital, Nigeria.
authors.forename: Nnodu Obigeli
authors.initials: NO
authors.lastname: Eunice
authors.affiliation: Department of Haematology and Blood Transfusion, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
authors.forename: Okocha Onyichide
authors.initials: OO
authors.lastname: Emmanuel
authors.affiliation: Department of Haematology, Faculty of Basic Medical Sciences, University of Ibadan.
authors.forename: Akingbola Titilola
authors.initials: AT
authors.lastname: Stella
authors.affiliation: Department of Haematology and Blood Transfusion University of Calabar Teaching Hospital Calabar, Nigeria.
authors.forename: Asuquo Inyama
authors.initials: AI
authors.lastname: Marcus
authors.affiliation: Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital Ikeja, Nigeria.
authors.forename: Balogun Modupe
authors.initials: BM
authors.lastname: Taiwo
authors.affiliation: Clinical Sciences Division, Nigerian Institute of Medical Research Lagos Nigeria.
authors.forename: Kalejaiye Olufunto
authors.initials: KO
authors.lastname: Olufela
authors.affiliation: Department of Haematology and Blood Transfusion, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
authors.forename: Aneke John
authors.initials: AJ
authors.lastname: Chinawaeze
authors.affiliation: Department of Haematology, College of Health Sciences, Benue State University, Makurdi-Benue State.
authors.forename: Joseph Aondowase
authors.initials: JA
authors.lastname: Orkuma
authors.affiliation: Department of Haematology and Blood Transfusion University of Sokoto Teaching Hospital Sokoto, Nigeria.
authors.forename: Gwarzo Gwarzo
authors.initials: GG
authors.lastname: Dalhat
authors.affiliation: Clinical Sciences Division, Nigerian Institute of Medical Research Lagos Nigeria.
authors.forename: Ujah Innocent
authors.initials: UI
authors.lastname: Otobo
mesh_terms: D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D009549:Nigeria / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Multiple myeloma; Nigeria; presentation; treatment modalities