Therapeutic Aspects and Outcome of Hematological Malignancies at the Military Hospital of Antananarivo, Madagascar

Abstract

Background: Currently, the prognosis of hematological malignancies continues to improve in developed countries. In developing countries, such as Madagascar, data on hematological malignancies treatment and outcome are often rare, incomplete, or nonexistent. Until 2011, there was only one cancer center in Madagascar. The Medical Oncology Unit of the Military Hospital of Antananarivo, Madagascar, managed hematological malignancies since December 2012. This pathology represents there the fourth most frequent cancer. Objectives: We aimed to describe the therapeutic aspects and outcome of hematological malignancies managed at this center. Methods: This was a longitudinal study (descriptive and analytic) carried out from December 1, 2012 to August 31, 2015 (33 months). We included all patients followed, then, excluded those without pathologic evidence, cases of monoclonal gammopathy of unknown significance, and cases of solid cancers. Results:We followed up 57 cases of hematological malignancies. The mean age was 49.4 ± 15.5 years and sex ratio (male/female) was 1.71. A total of 34 patients (60%) received specific treatment and 40% of the patients undertook only symptomatic treatment.The median follow-up time was 60 days and mean survival time was estimated at 410 ± 61 days for all patients combined. The mean survival time varied significantly according to the nosological subgroup and to the type of treatment received (P = 0.004). At the end of the study 20 patients (35.1%) died and 17 patients (29.8%) were lost to follow-up. Conclusions: Our results are globally similar to the results found in other African studies. Improving diagnosis, establishing a hematopoietic stem cell transplant center, and improving access to specific therapies should improve the prognosis of our patients.

Epidemiology of cancer in Antsiranana, northern Madagascar, 2021: First study in the oncology department

“…In our study, the sex ratio was 0.25%. This result is comparable to various Malagasy and African studies [2,3,5]. They would be linked to the predominance of gynecological cancers.…”

“…Randriamalala's study in southern Madagascar revealed 50 cases of cancer in 15 months from October 1, 2016 to December 31, 2017 [3]. Hasiniatsy's study in the capital showed 181 cases during 2013 [2]. This variation would be related to the number of the population.…”

“…In Madagascar the national cancer registry is only at the beginning stage. The Malagasy data available comes from various studies carried through a cancer diagnosis and treatment units [2,3]. The population of Antsiranana was to 2.01 million inhabitants in 2018 and accounts for 7.8% of the Malagasy population [4].…”

Epidemiology of gastrointestinal cancers in the hospital of Tambohobe Fianarantsoa, Madagascar

“…1 In Madagascar, given the absence of a cancer registry, epidemiological data on these cancers come mainly from the capital's hospitals, where colorectal cancers are the most frequent. 2,3 To our knowledge, no epidemiological studies of gastrointestinal cancers have been carried out in the province of Fianarantsoa. The aim of the study was to describe the epidemiological aspect of gastrointestinal cancers at the University Hospital of Tambohobe Fianarantsoa.…”

Epidemiology and clinical aspects of hematological malignancies at the military hospital of Antananarivo

“…8 In the Malagasy literature, we found only two studies on hematological malignancies: the first was about their odontostomatological manifestations at Joseph Ravoahangy Andrianavalona Teaching Hospital (CHU JRA) and the second was about their therapeutic and evolutionary aspects at the Military Hospital of Antananarivo. 9,10 No previous studies have examined either the epidemiology or clinical manifestations of all hematological malignancies in one center in Madagascar. Thus, we aimed to describe the epidemiology and clinical aspects of malignant hemopathies observed at the Medical Oncology Unit of the Military Hospital of Antananarivo.…”