Theses and Dissertations (Haematology)

The Occurence of multiple myeloma at Dr George Mukhari Hospital, Gauteng: a retrospective review (2004-2009)

2017-11-16T10:03:11Z

The Occurence of multiple myeloma at Dr George Mukhari Hospital, Gauteng: a retrospective review (2004-2009) Rankapole, Ruth Khutso BACKGROUND: Multiple myeloma (MM) is a rare age-related disorder with increasing incidence with advancing age. It is a B-cell malignancy characterised by monoclonal expression and accumulation of abnormal plasma cells in the bone marrow. It comprises about 1 % of all malignant tumours worldwide and 10% of haemopoietic neoplasms. MM accounted for 0.43% of newly diagnosed malignancies in South Africa in 1999 and Visser et al (2009), found the incidence to be 0.00054%. Mwambakana in 2000 at Ga-Rankuwa Hospital, now known as Dr George Mukhari Hospital (DGMH), found MM to be the commonest haematological malignancy. No clear risk factors have been identified in this disease. The natural history of MM is one of progressive bone destruction, refractory cytopenias and end-organ damage. The diagnosis and staging of MM is based on different criteria and systems. OBJECTIVES: To establish a profile of patients diagnosed with MM at DGMH from 1 January 2004 to 31 December 2009. METHODS: We conducted a descriptive retrospective review of medical records of patients diagnosed and treated for MM at DGMH from 2004-2009. RESULTS: Thirty-four patients' records were found. MM was found to be present in these patients as early as the third decade, more females than males were diagnosed and females were surviving longer than their male counterparts. Clinical features were not significantly different from those previously reported. The WHO 2001 diagnostic criteria created by Durie & Salmon and the International Staging System were used more frequently and most patients presented at an advanced stage of the disease. Thesis(M Med (Haematology)) -- University of Limpopo, 2011.

Retrospective study on HIV/AIDS associated haematological disorders found in bone marrow at Dr George Mukhari Hospital (DGMH), Pretoria

2017-11-16T10:03:10Z

Retrospective study on HIV/AIDS associated haematological disorders found in bone marrow at Dr George Mukhari Hospital (DGMH), Pretoria De Carvalho, Mariquinha Jose Manuel Moniz Background. Infection with human immunodeficiency virus (HIV) is associated with a range of haematological abnormalities including: ineffective haematopoiesis, infiltrative disease of the bone marrow, nutritional deficiency and peripheral destruction of blood cells secondary to splenomegaly and immune deregulation. Aim. To review and describe bone marrow abnormalities and associated peripheral haematological abnormalities, in HIV/AIDS patients. Methodology. This is a retrospective study. Data was extracted from DISA, the National Laboratory Health Service Laboratory Information System database at the DGMH Tertiary Laboratory from 2003 to 2007. Medical and laboratory records of 80 HIV positive patients who underwent bone marrow examination for investigation of fever and/or cytopenia were reviewed. All statistical analyses were performed on SAS® Release 9.1.3. Results. Twenty-five patients out of a total of 80 (31.25%), had pancytopaenia. Of the 25, eight (32%) were males and 17 (68%) were females. In this study, pancytopaenia was described as a haemoglobin concentration, granulocyte count and platelet count below normal ranges for age and gender. Among male patients in this study, five (17%) patients had TB out of 30. Among female patients, five (10%) out of 50 patients had TB. The majority of patients with malignancies were males six out of nine (67%). Three of the five patients with non-Hodgkin’s lymphoma (NHL) and all of the patients with multiple myeloma (MM) were males. Conclusions. Haematological abnormalities were present in all patients. Bone marrow involvement by TB was found in 12.5% in the study population. Malignancies were more frequent in males; three patients with NHL, two with MM and one with Kaposi sarcoma (KS). The difference in distribution was not statistically significant (p=0.391002). Recommendations. It is recommended that health education and health promotion focus on the control of biological carcinogenic agents such as EBV, HPV and HHV-8 by routinely testing for these agents and by promotion of positive reproductive behaviour among people living with HIV/AIDS. The use of non-invasive tests will be helpful in our setting where there is high TB prevalence. Thesis (M Med (Haematology))--University of Limpopo, 2010.

A retrospective study of acute lymphoblastic leukaemia in Paediatric patients at Dr George Mukhari Hospital (2003-2007)

2017-11-16T10:03:08Z

A retrospective study of acute lymphoblastic leukaemia in Paediatric patients at Dr George Mukhari Hospital (2003-2007) Swanepoel, Yolande Introduction: ALL (Acute Lymphoblastic Leukaemia) is the most common leukaemia in childhood. The two most important features predictive of outcome are age and presenting WBC at diagnosis. NCI risk criteria are applied to all children with precursor B-ALL, dividing them into NCI “high risk” (age < 1 year and ≥ 10 yrs, WBC > 50 x 10 9/ ) and NCI “standard risk” (age ≥ 1 year and < 10 yrs, WBC < 50 x 10 9/ ). Gender, immunophenotyping and genetic studies are other features that have been shown to be associated with outcome. Objectives: To determine the correlation between survival outcome of paediatric patients with ALL and different variables, e.g. biological, haematological, immunophenotypic and cytogenetic features at diagnosis, and to determine the duration of survival of a patient since the diagnosis of ALL, at Dr George Mukhari Hospital. Methods: This study was conducted over the period 2003-2007. Children diagnosed with ALL with ages ranging from 1-12 years, were identified. The hospital and laboratory records were analysed retrospectively. Early prognostic features were identified from patient data. Results: Descriptive statistical measures were used to summarize data. Twenty nine paediatric patients with ALL were identified of which 12 were female and 17 were male. The mean age of patients at diagnosis was 7,2 years. The presenting leucocyte count ranged from 2,5 to 325 x 10 9/ . Cytogenetic studies of three patients were available, all of which were unfavourable prognostic factors. Immunophenotyping revealed ten patients with T-cell ALL, 17 patients with B-cell ALL and two patients whose immunophenotype was unknown as recorded results were not available. Twenty one patients’ survival data were known. The longest duration of survival of a patient was 3,7 years. There were seven patients known to be alive at the end of the study period. Conclusion: The cases reported herein and those described in the literature demonstrate the importance of a careful and multidisciplinary approach in the diagnosis and evaluation of paediatric ALL. Thesis (M Med(Haematology))-- University of Limpopo (Medunsa Campus), 2008.