Gichuru Wanjiku, Abinya Nicholas A O, Odhiambo Andrew, Otieno Fredrick C F, Harrison Simon, Ong'ondi Matilda
Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya.
Nairobi Hospital Cancer Centre, Nairobi, Kenya.
Adv Hematol. 2024 Feb 12;2024:3208717. doi: 10.1155/2024/3208717. eCollection 2024.
Multiple myeloma (MM) is a chronic B-cell malignancy that involves proliferation of neoplastic clonal plasma cells in the bone marrow with circulating monoclonal immunoglobulins or constituent chains in serum or urine or both. It is a rare cancer with a lifetime risk of 0.76% and an age-adjusted incidence rate of 2.5-7.2 per 100,000 in high-income countries. There is a paucity of local data on the morbidity and treatment of MM.
This was a single-centre descriptive retrospective study at the Kenyatta National Hospital (KNH). The study population included inpatients and outpatients with a documented diagnosis of MM managed between 1 January 2014 and 31 December 2018. Demographic data, pathology reports, laboratory results, and clinical findings were transcribed and uploaded to a database, and data analysis was done using Stata 16® software.
A total of 207 patient files were reviewed. The median age at presentation was 60 years with a slight male preponderance. Bone pain was the predominant complaint in 59% (139/207) of patients, with 17% of patients presenting with paraparesis or paraplegia. For patients who underwent imaging, osteolytic bone lesions were identified in 90.6% (126/139). Anaemia was present in 71% (147/207) patients, hypercalcemia in 55.4%, and renal dysfunction in 38.2%. There were 25 different treatment regimens prescribed, with 13 patients (7%) being on bortezomib-based triplet therapy.
MM in KNH is a disease of the middle aged, affecting men and women almost equally and presenting mainly with bone pain and anaemia. Although there seems to be a general improvement in diagnosis and care, access to novel and less toxic agents for treatment is still wanting.
多发性骨髓瘤（MM）是一种慢性B细胞恶性肿瘤，涉及骨髓中肿瘤性克隆浆细胞的增殖，伴有血清或尿液或两者中循环单克隆免疫球蛋白或其组成链。它是一种罕见癌症，在高收入国家终身风险为0.76%，年龄调整发病率为每10万人2.5 - 7.2例。关于MM发病率和治疗的本地数据匮乏。
这是一项在肯雅塔国家医院（KNH）开展的单中心描述性回顾性研究。研究人群包括2014年1月1日至2018年12月31日期间确诊为MM并接受治疗的住院患者和门诊患者。人口统计学数据、病理报告、实验室结果和临床发现被转录并上传至数据库，使用Stata 16®软件进行数据分析。
共审查了207份患者档案。就诊时的中位年龄为60岁，男性略占优势。59%（139/207）的患者主要主诉为骨痛，17%的患者表现为轻瘫或截瘫。接受影像学检查的患者中，90.6%（126/139）发现溶骨性骨病变。71%（147/207）的患者存在贫血，55.4%存在高钙血症，38.2%存在肾功能不全。共开出25种不同的治疗方案，13名患者（7%）接受基于硼替佐米的三联疗法。
KNH的MM是一种中年疾病，几乎同等程度地影响男性和女性，主要表现为骨痛和贫血。尽管诊断和治疗似乎总体有所改善，但获得新型且毒性较小的治疗药物仍然不足。
