Lateef Salawu

Familial Burkitt's lymphoma in Nigerians.

Three Nigerian sib-pairs with familial Burkitts lymphoma (BL) seen between 1986 and 1996 are described. Their ages ranged from 4 to 20 years (median 9.5), and there were five males and one female. The mean age interval between each pair at presentation was 4 years (3-6) and the mean time interval 22 months (0.3-41). Two of the sib-pairs were sex-concordant, including a set of monozygotic twins. Five of the patients presented in stage C and one in stage A. Parental consanguinity was not found in any group. Space-clustering was confirmed in all three but time-clustering in only one. The occurrence of BL in multiple members of the same family, the presence of sex concordance and the relatively wide variation in the time of onset of disease between each pair suggest genetic predisposition as a possible additional aetiological factor for BL in the families affected.

Chronic Myeloid Leukemia in Nigerian Patients: Anemia is an Independent Predictor of Overall Survival:

Objectives The advent of the tyrosine kinase inhibitors has markedly changed the prognostic outlook for patients with Ph+ and/or BCR-ABL1+ chronic myeloid leukemia (CML). This study was designed to assess the overall survival (OS) of Nigerian patients with CML receiving imatinib therapy and to identify the significant predictors of OS. Methods All patients with CML receiving imatinib from July 2003 to June 2013 were studied. The clinical and hematological parameters were studied. The Kaplan-Meier technique was used to estimate the OS and median survival. P-value of <0.05 was considered as statistically significant. Results The median age of all 527 patients (male/female = 320/207) was 37 (range 10-87) years. There were 472, 47, and 7 in chronic phase (CP), accelerated phase, and blastic phase, respectively. As at June 2013, 442 patients are alive. The median survival was 105.7 months (95% confidence interval [CI], 91.5-119.9); while OS at one, two, and five years were 95%, 90%, and 75%, respectively. Multivariate Cox regression analysis revealed that OS was significantly better in patients diagnosed with CP (P = 0.001, odds ratio = 1.576, 95% CI = 1.205-2.061) or not in patients with anemia (P = 0.031, odds ratio = 1.666, 95% CI = 1.047-2.649). Combining these variables yielded three prognostic groups: CP without anemia, CP with anemia, and non-CP, with significantly different median OS of 123.3, 92.0, and 74.7 months, respectively (χ2 = 22.042, P = 0.000016). Conclusion This study has clearly shown that for Nigerian patients with CML, the clinical phase of the disease at diagnosis and the hematocrit can be used to stratify patients into low, intermediate, and high risk groups.

Seroprevalence of transfusion transmissible viral markers in sickle cell disease patients and healthy controls in Ile-Ife, South-Western Nigeria: A case–control study

Background: The risk of acquiring transfusion transmissible viral infections is said to be higher in patients requiring regular blood transfusions such as those with sickle cell disease (SCD). Aim: We determined the seroprevalence of blood transfusion viral markers among our patients with SCD. Subjects and Methods: This a case–control analytical study consisting of 82 confirmed SCD patients on routine follow-up at our facility in steady state and 90 age-matched controls. Demographic and transfusion history were recorded while 5 ml of blood was drawn for hematocrit levels, and serum tested for transfusion transmissible viral markers for hepatitis B, (hepatitis B surface antigen [HBsAg], hepatitis B surface antibody [HBsAb], hepatitis B e antigen [HBeAg], hepatitis B e antibody [HBeAb], hepatitis B core antibody [HBcAb]), hepatitis C virus (HCV) and human immunodeficiency viruses (HIVs) using the rapid test kits. Ethical approval for the study was obtained from the Institutional Review Board and each participant gave informed consent. Data were analyzed using descriptive and inferential statistics. Results: The seroprevalence of HBsAg, HBsAb, and HBeAg in cases was 2 (2.4%), 7 (8.5%), and 0 (0.0%), respectively, whereas it was 7 (8.5%), 11 (13.4%), 6 (7.3%), and 2 (2.4%) for HBeAb, HBcAb, HCV, and HIV antibodies. Compared to the controls, cases had higher prevalence rate of HBeAb ( P = 0.005). No significant difference was observed in those with or without low hematocrit (≤18%) or those that received blood transfusion and those that did not ( P > 0.05). Conclusion: We conclude that blood transfusion did not significantly increase the seroprevalence of markers of transfusion transmissible viral infection in SCD patients.

AIDS-related lymphomas in Nigeria an emerging phenomenon

Results There were 161 cases comprising NHL, 42 (25.5%); HL, 15 (9.3%), and BL, 104, (64.6%). Seven (4.3%), aged 2-49 (median = 41) years were retroviral positive. Of these, 4 (3 males, 1 female, aged 28-49 (median = 38.5) years) had NHL, 2 (both females) HL, and 1 case, a 2-year-old boy with HIV since birth, had Burkitt’s and an HIVpositive mother. All, except one female with stage 1 HL, presented late (at least clinical stage IIIb). Three patients with NHL and 1 with late-stage HL succumbed to their disease within 1-3 weeks of hospital admission. The remaining 3 patients had been responding satisfactorily to chemotherapy (CHOP for NHL, ABVD for HL, and COM for Burkitt’s lymphoma.)

Severe iron deficiency anaemia in a 37-year-old with HBSC disease: a case report and review of literature.

Background: Iron deficiency anaemia (IDA) is not a recognised complication of sickle cell disease; it is uncommon in an adult patients. However, it could occur in children with the disease on the background of a significant nutritional deficiency. Method: Clinical note of the patient was retrieved for relevant information. The date of first contact with health facility, and subsequent follow-up clinical status was noted. The steady state blood counts, the clinical and laboratory findings at presentation of severe IDA was reviewed. Result: The patient runs a mild disease and was haemoglobin SC. The severe IDA was precipitated by ascaris lumbricoides infestation. This necessitated packed cell transfusion for the first time ever in this patient. Conclusion: There should be a high index of suspicion for worm infestations in previously untransfused SCD patients presenting with severe anaemia. The role of iron-deficient state in sickle cell disease amelioration needs further evaluation. Key words: sickle cell disease, iron deficiency, worm infestation.