Characteristics and outcomes of patients with multiple myeloma at the Uganda Cancer Institute.

Clement D Okello,Jackson Orem,Cheryl L Thompson,Matthew M Cooney,Andrew J Cowan,Yusuf Mulumba,Henry Ddungu,Kristen Welch,Abrahams Omoding

doi:10.4314/ahs.v21i1.11

Abstract

Data on multiple myeloma (MM) in sub-Sahara Africa is scarce. In Uganda, there is a progressively increasing incidence of MM over the years. We performed a retrospective study on 217 patients with MM at the UCI using purposive sampling method. The objectives of the study were to determine the clinical characteristics, treatment outcomes, 5 year overall survival and predictors of survival of patients with MM at the UCI from 01 January 2008 to 31 December 2012. There were 119 (54.8%) males; the mean(SD) age of the study population at presentation was 59(12.8) years; 183(84.3%) patients presented with bone pain, and 135 (61.9%) had skeletal pathology; 186(85.3%) were HIV negative, and 152(70%) had Durie-Salmon stage III. The median overall survival was 2.5 years, (95% CI, 0.393-0.595); factors significantly associated with worse survival were Durie-Salmon stage III disease, HR=5.9, 95% CI (1.61 - 21.74; P=0.007) and LDH >225 U/L HR=3.3, 95% CI (0.57 - 5.92; P=0.029). Most patients with multiple myeloma at the UCI were diagnosed at a relatively young age, presented with late stage disease and bone pain, and had a shorter survival time. Factors associated with worse survival were Durie-Salmon stage III and LDH >225 U/L.

Highlights

Multiple myeloma (MM) is the second most common hematologic malignancy in the United States[1,2,3] and it is the most common hematologic malignancy among African Americans in the US4
Our data is consistent with the observation that MM is more prevalent in males[26]; compared with the global statistics which reports the mean age at diagnosis of MM as 66, 27-29 our data depicts a younger mean(SD) age at diagnosis of 59 (12.8) years
A recent report by Madu et al.[15] in 2014 on a retrospective analysis of 32 patients diagnosed with multiple myeloma in Nigeria showed a median age at diagnosis of 62 years

Summary

Introduction

Multiple myeloma (MM) is the second most common hematologic malignancy in the United States[1,2,3] and it is the most common hematologic malignancy among African Americans in the US4. A report by the World Health Organizatin in 2014 indicates that multiple myeloma was responsible for mortality in 6.0% of males and 5.0% of females among 9,100 and 9,000 cancer deaths respectively[17]. Patient characteristics, such as race and environmental factors, are important determinants in the aetiology and prognosis of MM11,18. We performed a retrospective study on 217 patients with multiple myeloma at the Uganda Cancer Institute to determine their clinical characteristics, treatment outcomes, and 5 year overall survival ad predictors of survival

Objectives

Methods

Results

Conclusion