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1.
Hematology ; 28(1): 2261803, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37746751

ABSTRACT

INTRODUCTION: In Madagascar, the epidemiologic, therapeutic, and evolutionary aspects of multiple myeloma remain poorly understood. Our objectives were to describe the cases, report factors associated with mortality, and estimate patient survival. PATIENTS AND METHOD: This was a retrospective descriptive and analytical study conducted in five teaching hospitals in Madagascar: HJRA and CENHOSOA (Antananarivo), CHUPZAGA (Mahajanga), CHUAT (Toamasina) and CHUT (Fianarantsoa). The study included patients diagnosed with multiple myeloma between January 1, 2010 and December 31, 2021. RESULTS: Of the 11,374 cancer patients, 75 (0.66%) had multiple myeloma. The mean age of the patients was 59.9 years (±8.9) and the sex ratio was 1.5. Arterial hypertension was observed in 32% of the patients. The most common symptom of myeloma was bone pain (n = 48; 64%). Forty-six patients (61%) were diagnosed with stage III myeloma and 28 patients (37.3%) with stage IIIA myeloma according to the Durie-Salmon classification. Anemia, renal failure, hypercalcemia and fractures were present in 53%, 37%, 21% and 28% of cases, respectively. Fifty-four patients received specific treatment. The combination of melphalan-prednisone-thalidomide was used in 79.63% of cases, and one patient had received autologous stem cell transplantation. Eleven patients (14.67%) died. Chronic kidney disease (p = 0.009), smoking (p = 0.028) and two associated comorbidities (p = 0.035) were associated with mortality. The median overall survival was 45.5 months. CONCLUSION: Patient survival is shorter than reported in the literature. The high mortality rate is due to comorbidities and limited access to recommended therapies.


Subject(s)
Hematopoietic Stem Cell Transplantation , Multiple Myeloma , Humans , Middle Aged , Multiple Myeloma/epidemiology , Multiple Myeloma/therapy , Madagascar/epidemiology , Retrospective Studies , Transplantation, Autologous
2.
Clin Case Rep ; 9(4): 2153-2157, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33936655

ABSTRACT

In chronic polyarthritis, the presence of macroglossia with absence of rheumatoid factor and anti-CCP antibodies may be suggestive of amyloid arthopathy. Clinical evaluation takes precedence over classification criteria.

3.
Emerg Infect Dis ; 20(10): 1739-41, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25272365

ABSTRACT

Melioidosis is an often fatal infectious disease affecting humans and animals in the tropics. Only sporadic cases have been reported from Africa and the Indian Ocean region. We describe 2 confirmed autochthonous cases of human melioidosis in Madagascar, both from novel genotypes of Burkholderia pseudomallei.


Subject(s)
Melioidosis/epidemiology , Anti-Bacterial Agents/therapeutic use , Fatal Outcome , Humans , Madagascar/epidemiology , Male , Melioidosis/drug therapy , Middle Aged
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