Myelomatosis: clinical and laboratory features in Nigerians.

ABSTRACT

BACKGROUND: The objective was to investigate the factors influencing survival of Nigerians with Myelomatosis. MATERIALS AND METHODS: The pre-therapy clinical and laboratory features of patients managed at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, between June 1986 and May 2001 were studied. Diagnosis was based on history of bone pain, marrow plasmacytosis, osteolytic bone lesions, serum biochemical profile, monoclonal (M) band, and/or Bence-Jones proteinuria. RESULTS: Twenty-seven patients (22 males, 5 females) aged 15 to 81 (median, 60) years were managed within the study period. Of the 27, 5 (18.5%) were 40 years or younger while 14(51.8%) were 60 years or older. Multiple myeloma (MM) is the main sub-type seen (81.5%). Majority presented with bone pain, weakness, fatigue and inability to walk. Anaemia, high erythrocyte sedimentation rate and bone marrow plasmacytosis were the significant haematological findings. Serum protein electrophoresis showed M-band in 6 cases of MM, with 3 of them also having Bence-Jones proteinuria. Renal function impairment and hypercalcaemia occurred mainly in those with MM. Multiple osteolytic lesions and pathological fractures were recorded in 44% of those with MM and Solitary Myeloma of Bone. Twelve patients were already dead at the time of analysis, with renal failure being the cause in 8 and anaemia in the rest. The median survival was 1.2 months. CONCLUSIONS: We could conclude that the presenting features of Nigerian patients with myelomatosis are not different from reports elsewhere, but high default rate and short survival are particularly noted.