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Category: Volume 08 Issue 05 May 2020
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Title: Hematological Malignancies Pattern among Bangladeshi Adults

Authors: Lt Col S. M.Rahid Sarwar, Dr Hafiza Lona, Dr Durba Halder, Dr Shahjada Selim

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.02

Abstract

 

Introduction: As a developing country, Bangladesh facing many challenges, especially in the health sector. Among all other crucial diseases, cancer kills more people than tuberculosis, HIV and malaria combined. Hematological malignancies (HM) are not rare in our country. It affects all ages and genders. Hematological malignancies are a group of cancer that arises from a malignant transformation of cells of the bone marrow or lymphatic system. There are several classification systems for hematological malignancies. In a worldwide consensus classification, the World Health Organization (WHO) first classified hematological tumors.

Methods: It was a cross-sectional descriptive study. Data collected from the Department of pathology and hematology unit of internal medicine of Dhaka Medical College Hospital, Bangabandhu Sheikh Mujib Medical University, Combined Military Hospital (CMH) Dhaka, Sir Salimullah Medical College & Mitford Hospital, National Institute of Cancer Hospital, Chittagong Medical College Hospital and Rajshahi Medical College Hospital from September 2018 to till October 2019. Hematological malignancies were analyzed clinically with laboratory parameters. They were initially analyzed with complete blood counts, peripheral smearand diagnosed on the basis of bone marrow morphological assessment, immunophenotyping, cytogenetic molecular markers, histopathology and immunohistochemistry of excised lymph node when applicable. Plasma cell dyscrasias were assessed clinically for features of CRAB (hypercalcemia, renal impairment, anemia, and lytic lesion) and evaluation was done by hemogram, biochemical parameters, and skeletal survey. Later plasma cell dyscrasias were diagnosed on the basis of bone marrow study, immunofixation electrophoresis, serum-free light chain assay, serum protein electrophoresis and myeloma defining events.

Results: A total number of 1100 cases of hematological malignancies (HM) patients were selected in the study. Among them lymphoid neoplasm (LN) was the commonest hematological malignancies which were 60% and myeloid neoplasm (MN) 40%. In LN, precuorsor lymphoid were (7.27%), B and T lymphoblastic lymphoma/ leukemia (ALL) both were 3.6%. Mature B cell neoplasm (MBCN) was 43.6%, hodgkin’s lymphoma (HL) 5.6% and mature T cell neoplasm (MTCN) 3.6%.In myeloid neoplasm (MN), myeloproliferative neoplasm (MPN) accounted for 20.8% followed by acute myeloid leukemia (AML) with 16.2% and myelodysplastic syndrome (MDS) 3%. According to the classification of age groups of 21-40 years, non-hodgkinslymphoma (NHL) was the commonest(2.7%), under MCBN of lymphoid neoplasm. Whereas, chronic myeloid leukemia (CML) was the commonest (5.46%),among the age group of 41-60 years under MPN of myeloid neoplasm.In older group > 60 years, plasma cell neoplasm (PCN) was the most common (5.5%).Male was more predominant than female. Male were 23.6% and female 5.5% with a ratio 4.3:1

Conclusion: HM can occur in any age group. Overall men are more affected with HM than women.In both male and female lymphoid malignancies is frequent HM. There is a difference in distribution patterns and subtypes of hematological malignancies at different age groups.

Keywords: Hematological malignancies; lymphoid neoplasm; myeloid neoplasm.

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Corresponding Author

Dr Shahjada Selim

Associate Professor, Department of Endocrinology Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh