Caroline Edijana Omoti, Casmir Edisma Omuemu.
Multiple myeloma: a ten year study of survival and therapy in a developing nation.
J Pak Med Assoc Jan ;57(7):341-4.

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 to2003. 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) out numbered the females (n=10), with a median age of 54 years. The mean duration of survival of all patients was 7months (median 3months; 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 than21 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. Conclusion: 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 (JPMA 57:341:2007).

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