Pattern of Haematological Malignancies in Ilorin, Nigeria: A Ten Year Review

摘要

A 10 year retrospective survey of haematological malignancies in Ilorin, Nigeria, was carried out based on data from the Records Department and the Cancer Registry of the Morbid Anatomy Department of the University of Ilorin Teaching Hospital.The aim was to determine the current pattern of haematological malignancies in the study area and compare with previous reports from other parts of Nigeria and worldwide.A total of 370 cases of haematological malignancies which were diagnosed within the study period (January 1996 to December 2005) by means of available haematological laboratory methods and histological examinations were analyzed. The distribution of the various haematological malignancies recorded were: ALL 18(4.9%), AML 18(4.9%), CLL 20(5.4%), CML 42(11.4%), Hairy cell leukaemia 2(0.5%), NHL 104(28.1%), Hodgkin’s disease 42(11.4%), Burkitt’s lymphoma 102(27.5%), Multiple myeloma 20 (5.4%) and Plasma cell leukaemia 2(0.5%)The lymphomas were found to constitute the highest prevalence (67.0%), with non-Hodgkin’s lymphoma being the commonest, accounting for about 42% of the lymphoma cases. Hairy cell leukaemia and plasma cell leukaemia were the least seen, each constituting 0.5% of the cases.The distribution of the various haematological malignancies in this study is similar to the pattern reported in previous studies, although, there appears to be generally a lower prevalence of haematological malignancies recorded when compared to the earlier findings.Difficulties in management and poor outcome observed for the various haematological malignancies are attributable to late presentation, high patients default rate, poverty and shortage of chemotherapeutic agents. Introduction Haematological malignancies are primary cancers of the blood and blood forming organs i.e. the bone marrow and lymphoid tissues. They are usually clonal in origin and are quite often associated with chromosomal abnormalities [1]. These malignancies are induced by genetic damage or mutation in somatic cells, which can result from environmental agents such as chemicals, ionizing radiation and viral agents. The pattern of clinical presentation of these malignancies is variable and depends largely on the nature of the disease and its extent. They have a worldwide distribution and can occur at all ages and in both sexes. Although, there are differences between the various types as regards the age and sex incidence, a changing pattern in the clinical presentation and distribution has been reported in various communities over the years [23456789]. In Ibadan, the annual incidence for acute lymphoblastic leukemia and acute myeloblastic leukemia had been reported to be 3.7 per 106 per year and 1.9 per 106 per year respectively [23]. Acute leukaemias were also reported to be the commonest form of leukaemias in Ethiopia, constituting 63.8% of all cases reviewed, acute myeloid leukaemia(AML) being three times more common than acute lymphoblastic leukaemia(ALL) [6].In the United States of America, it was reported that haemopoietic malignancies accounted for approximately 6-8% of cancer incidence in both sexes, the incidence of acute leukemias being about 34 per million populations [78]. Malignant lymphomas have been among the most extensively studied neoplasms due to their rising incidence, the important insights they provide regarding cancer pathogenesis, the high treatment response rates and their potential curability [1011]. The annual incidence for non-Hodgkin’s lymphomas (NHL) was reported to be about eight cases per million populations among Zimbabweans [10]. In the United States of America (USA), the annual death rate from lympho-reticular malignancies is approximately 60 per million, of which Hodgkin’s lymphoma accounted for 35%, and NHL for more than 45% [11].The incidence rates for all lymphoid and granulocytic leukaemias in Ibadan for the period 1978-1982 ranged between 3.7 per 106 and 7.6 per 106 per year and between 5.0 per 106 to 10.0 per 106 per year re