BackgroundThe global burden from cancer is rising, especially as low-income countries like Bangladesh observe rapid aging. So far, there are no comprehensive descriptions reporting diagnosed cancer group that include hematological malignancies in Bangladesh.MethodsThis was a multi-center hospital-based retrospective descriptive study of over 5000 confirmed hematological cancer cases in between January 2008 to December 2012. Morphological typing was carried out using the “French American British” classification system.ResultsA total of 5013 patients aged between 2 to 90 years had been diagnosed with malignant hematological disorders. A 69.2% were males (n = 3468) and 30.8% females (n = 1545), with a male to female ratio of 2.2:1. The overall median age at diagnosis was 42 years. Acute myeloid leukemia was most frequent (28.3%) with a median age of 35 years, followed by chronic myeloid leukemia with 18.2% (median age 40 years), non-Hodgkin lymphoma (16.9%; median age 48 years), acute lymphoblastic leukemia (14.1%; median age 27 years), multiple myeloma (10.5%; median age 55 years), myelodysplastic syndromes (4.5%; median age 57 years) and Hodgkin’s lymphoma (3.9%; median age 36 years). The least common was chronic lymphocytic leukemia (3.7%; median age 60 years). Below the age of 20 years, acute lymphoblastic leukemia was predominant (37.3%), followed by acute myeloid leukemia (34%). Chronic lymphocytic leukemia and multiple myeloma had mostly occurred among older patients, aged 50-over.ConclusionsFor the first time, our study presents the pattern and distribution of diagnosed hematological cancers in Bangladesh. It shows differences in population distributions as compared to other settings with possibly a lower presence of non-Hodgkin lymphoma. There might be under-reporting of affected women. Further studies are necessary on the epidemiology, genetics and potential environmental risk factors within this rapidly aging country.
Severe anaemia is usually treated with red blood cell (RBC) transfusion and in some cases moderate anaemia also requires transfusion. Traditionally one unit of red blood cells is transfused to increase the hemoglobin (Hb) level by 1 gm/dl, although no consensus guideline is available in our country. This study was done to see how much hemoglobin level was increased after transfusion of one unit of red blood cells in cancer patients with anaemia in our people. During the period of July 2012 to December 2012, 160 patients were studied in the Department of Transfusion Medicine of National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka. All patients were aged >18 years of both sexes having a haemoglobin level of <10 gm/dl, and had no transfusion of platelets, plasma or colloid within 24 hours of red cells transfusion or with active bleeding or drain loss. The average increment of haemoglobin level was 0.74 gm/dl (0.74±0.11) gm/dl for each unit of red blood cells transfusion. This rise of haemoglobin level was different from the traditional calculation which was statistically significant (p<0.01). The traditional calculation for correction of anaemia by red blood cell transfusion is not suitable for the people of our country. JCMCTA 2014 ; 25 (2) : 21-25
Multiple myeloma is a plasma cell neoplasm characterized by abnormal proliferation of clonal cells in the bone marrow. Anaemia is generally the most common feature from hematologic aspect and bone pain being the other important symptom, but pancytopenia as the presenting feature is unusual. Here, we shared our experience of 3 cases with non-specific symptoms with pancytopenia which on through evaluation revealed our diagnosis. A hospital based observational descriptive case series was conducted wherein all the cases of multiple myeloma presenting with pancytopenia were included. Complete blood picture, peripheral smear, bone marrow aspirate and serum protein electrophoresis were reviewed and analysed. Pancytopenia as the initial presenting feature of multiple myeloma is an unique manifestation and diagnosing such cases require high degree of suspicion to avoid delay in the initiation of treatment.
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