Hepatocellular carcinoma in Qatar

The main aim of this study was to report and discuss epidemiological, etiological, type of treatment and data on survival of the patients with each mode of treatment using available data for patients with hepatocellular carcinoma [HCC] who have been diagnosed at Hamad Medical Corporation during the period March 2004-December 2010 inclusive. Retrospective analysis of 150 patient's data had been done, including demographic, epidemiological, etiological disease status assessment with child Pugh criteria, modes of treatment and treatment related outcome. Patient's various characteristics such as demographic, epidemiological, and other clinical characteristics were summarized using an appropriate descriptive statistics. Univariate Kaplan-Meier survival curve analysis was performed to estimate overall and group wise survival at different time points. Furthermore, the log-rank test was applied to determine any statistical difference in survival among various subgroups. In addition, the multivariate Cox regression method was used to assess the significant effects of various prognostic factors on outcome survival time. The mean age of the studied HCC patients was 58.8 years [31-87years] with a male: female ratio of 3:1 [76% Male 24% Female]. There were 48 [32%] Qatari and 102 [62%] non- Qatari patients. The underlying etiology HCV was the most common [45%] similar to Western European countries, HBV in [27%], alcoholic liver disease only in 6 [4%], Child-Pugh assessment was A in [33%], B in [37%] and C in [30%], nearly half of the patients [53%] were in advanced stage and had palliative treatment, the other half had chemoembolization in [17%], systemic therapy sorafenib in [13%], surgery [liver resection or transplantation] in [12%] and local ablation in [5%]. HCC is more common in males [ratio M: F 3:1]. HCV is the most common underlying cause, similar to the pattern in western European countries. The survivals in our patient were comparable to other studies reported in the literature. Patients who had chemoembolization had the longest median survival [Median = 27 months, 95% CI [20.27- 33.72]. Majority of cases [53%] were diagnosed at advanced stage. To improve the outcome of treatment of HCC patients, the number of early and very early stage diagnosis should be increased by improving the implementation and effectiveness of the strategic screening program

TAC protocol in early breast cancer: Al Amal hospital experience

To assess the efficacy and the tolerability of TAC [docetaxel, doxorubicin, and cyclophosphamide] protocol in early breast cancer patients with node positive in the adjuvant treatment 64 patients [median age 46 years] with early node positive breast cancer were studied from October 2003 to May 2009 according to certain inclusion criteria. They received TAC protocol chemotherapy; Disease free survival [DFS], Overall Survival [OS] and toxicity profile were assessed. All except one received six cycles of chemotherapy according to TAC protocol. Median follows-up was 60 months. Disease free [DFS] and Overall Survival [OS] were 77% and 87% respectively. The chemotherapy was well tolerated and the toxicity profile was better in comparison to previously published studies. It is concluded that TAC protocol in the adjuvant treatment of early breast cancer is effective and well-tolerated as evident by the toxicity profile provided the G-CSF is started as primary prophylaxis from the first cycle

Clinical and epidemiological characteristics of lung cancer cases in Qatar

This study documents for the first time the clinical and epidemiological characteristics of lung cancer cases in Qatar from 1998 to 2005. The age-standardized incidence rate was higher than that in many other Gulf countries: 8.95 per 100 000 [15.2 per 100 000 for males; 3.95 per 100 000 for females]. Mean age at diagnosis was 57.5 years. Most patients were current smokers or ex-smokers at the time of diagnosis [82.5%]. Unlike other Gulf countries, adenocarcinoma was the predominant type in both Qatari nationals and expatriates [43.9% of lung cancer types]. Many cases were in an advanced stage at diagnosis [64.2% at stage IV]. Incomplete information was available on mortality rate due to the migration of expatriates

Adult T-cell Leukemia / Lymphoma: First case report from Qatar

In what appears to be the first case of Adult T-cell Leukemia/Lymphoma [ATLL] reported in Qatar and Middle Eastern Arab countries, a 39-year-old lady presented first with pneumocystis carinii pneumonia and hypercalcaemia and later showed the full picture of ATLL, splenomegaly leukocytosis, skin rash, and bone marrow infiltrations. She responded well to chemotherapy, with complete remission after four cycles of combination chemotherapy but the prognosis of patients with ATLL is poor. Although patients may respond initially to treatment with combination chemotherapy regimens devised for advanced, aggressive Non-Hodgkin's Lymphoma [NHL], relapses are common with a median survival of eight months and a four-year survival of 12 percent

Anaplastic myeloma with deposits in three different sites: Case report and literature review

Anaplastic myeloma is a rare aggressive disease that is resistant to most chemotherapeutic agents and radiotherapy. It develops usually after a diagnosis of classical multiple myeloma and is associated with at least one extramedullary plasmacytoma site. We report a case of this rare disease in a patient who had no previous illness and presented to us with more than one extramedullary plasmacytoma site: a mass in the right anterior chest wall, a swollen scrotum and multiple nodular skin lesions mainly in the legs

Unusual presentation of peripheral t-cell lymphoma

Mature or peripheral T cell lymphomas [PTCL] are uncommon in most parts of the world and account for only 10-15% of all non-Hodgkin's lymphomas [NHLs]. They usually occur in middle-aged to elderly patients, 68% presenting with features characterized by a disseminated disease, with systemic symptoms in nearly half of them [45%], bone marrow [BM] involvement in a quarter [25.8%], andextranodal disease in a third [37%]. We report for the first time a patient with a lesion on the glans penis, an unusual site

IgA kappa chain myeloma with cast nephropathy in a man with type 2 diabetes mellitus and retinopathy

A 68-year-old gentleman with a long history of type 2 diabetes mellitus and recurrent multidrug resistant urinary tract infection and a recent history of a carbuncle, presented with a one week history of fever and dysuria. Laboratory results included erythrocyte rouleaux formation, ESR 121 mm/h, creatinine 217umol/l, total protein 83 g/l, albumin 32g/l, and Bence- Jones protein in k urine. Skull X-ray showed multiple lytic lesions. Serum frotein electrophoresis showed a monoclonal band of 33g/l of IgA kappa, IgG 665 mg/dl, and IgM 26.9 mg/dl. Bone marrow aspirate showed an infiltration of plasma cells. Renal biopsy showed a mild cast nephropathy with mild diabetic glomerular disease. The patient was assessed as stage IIIB multiple myeloma IgA kappa type and was started on chemotherapy MP protocol [oral Melphalan 5 mg/sq m body surface area plus oral prednisolone 60mg/sq m body surface area for four days every four weeks] after which he became stable