Documentation of Myeloproliferative Disorder as the Commonest Hematological Malignancy in Predominant Rural Based Pilot Study at Punjab (India): An Incidental Finding or Association.
Keywords:
Bone marrow, India, Malignancy, Punjab, Spectrum
Abstract
Background: Pilot studies (standard scientific tool) are helpful for researchers in conducting preliminary analysis before committing resources for a main study to follow. The present pilot study was undertaken in the northern part of India so as to take a glimpse of the pattern of hematological malignancies in an area which is mostly based on the agricultural economy and the hazards associated with it. These demographic based studies are often helpful in defining the burden and to ascertain the trends of the disease in the selected population.Method: A 3 year retrospective study was conducted in the hematopathology unit of the Department of Pathology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab (India) from a period of January 2012 to December 2014. Data regarding demographic/epidemiological details including clinical presentation, indication for the procedure was noted. Only the cases of hematological malignancies were included in the study. The results thus obtained were recorded and analyzed by descriptive statistics.Results: Of 1840 cases, 147 (7.98%) were hematological malignancies with Male to Female ratio being 2:1. After retrieving the residential records, it was noted that most of the patients were natives of Punjab state. The most common peripheral blood finding in hematological malignancies cases were pancytopenia ( 38.09 % ) , followed by bicytopenia ( 27.2 % ). According to the clinical presentation most common presentation recorded was hepatomegaly (42.1%), followed by splenomegaly (28.57%). The commonest hematological malignancy in our study was MPD (Chronic Myeloid Leukaemia primarily) followed by Lympho-proliferative disorders (which included Chronic Lymphocytic Leukaemia, Non Hodgkin’s Lymphoma and Hairy Cell Leukaemia). Combining both the categories, the so called chronic leukaemias contributed almost 2/3 of cases (72.78%).Conclusions: In contrast to most of the reported institutional based cases from India and the neighboring countries (including many developing countries of Asia) which have recorded acute leukaemia (ALL/AML) overall as the most common hematological malignancy ; the higher incidence of chronic leukaemias in our study is interesting.The finding of CML as more common of the chronic leukaemias in comparison to the CLL and other LPD’s is noteworthy. This trend needs to be watched carefully and a further study is planned to monitor the overall outcome over the next few years.References
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2. Rodriguez-Abreu D, Bordoni A, Zucca E. Epidemiology of hematological malignancies. Ann Oncol 2007;1:i3-i8.
3. Ghartimagar D, Ghosh A, Narasimhar R, Talwar OP. Hematological and non-hematological malignancies in a tertiary care hospital in Nepal- 11 year study. Nepal Med Coll J 2012; 14(3): 187-92.
4. Tahlan A, Bansal C, Palta A, Chauhan S. Spectrum and analysis of bone marrow findings in anemic cases. Indian J Med Sci 2008;62(8):336-9.
5. Rahim F, Ahmad I, Islam S, Hussain M, Khattak TA, Bano Q. Spectrum of hematological disorders in children observed in 424 consecutive bone marrow aspirations/biopsies. Pak J Med Sci 2005;21(4):433-6.
6. Al-Ghazaly J, Al-Selwi AH, Abdullah M, Al-Jahafi AK, Al-Dubai W, Al Hashdi A. Pattern of haematological diseases diagnosed by bone marrow examination in Yemen. A developing country experience. Clin Lab Haematol 2006;28:376-81.
7. Ali N, Anwar M, Ayyub M, Nadeem M, Ejaz A, Qureshi AH, et al. Hematological evaluation of splenomegaly. J Coll Physicians Surg Pak 2004;14(7):404-6.
8. Murakami J, Shimizu Y. Hepatic Manifestations in Hematological Disorders. Int J Hepatol 2013;2013:484903. doi: 10.1155/2013/484903. Epub 2013 Mar 31.
9. Ekwere TA, Benson Ino-Ekanem M, Motilewa O. Indications and Spectrum of Haematological Disorders from Bone Marrow Aspiration Examination: A Three Year Review Study. Global J Hematol Blood Transfus 2015;2:4-8.
10. Babutaunde A, Awiwero C, Olatunji P, Durotoye I. Pattern of haematological malignancies in Iloron, Nigeria: A ten year review. Internet J Hematol 2008;5(2):15-20.
11. Jha A. Spectrum of haematological malignancies and peripheral cytopenias. J Nepal Health Res Counc 2013;11(25):273-8.
12. Pudasaini S, Prasad KBR, Rauniyar SK, Shrestha R, Gautam K, Pathak R, et al. Interpretation of bone marrow aspiration in hematological disorder. J of Pathology of Nepal 2012; 2: 309-12.
13. Kusum A, Negi G, Gaur DS, Kishore S, Meena H, Sharma A, et al. Hematological malignancies diagnosed by bone marrow examination in a tertiary hospital at Uttarakhand, India. Indian J Hematol Blood Transfus 2008;24(1):7-11.
14. Levy LM. The pattern of Leukaemia in adult Zimbabweans. Centr Afr J Med 1984;30 (4):57-63.
15. Shamebo M. Acute Leukaemias in adult Ethiopians in a teaching hospital. Ethiop Med J 1994;32(1):17-25.
16. Xie Y, Davies SM, Xiang Y, Robison LL, Ross JA. Trends in Leukaemia incidence and survival in the United States (1973-1998). Cancer 2003;97(9):2229-35.
17. Wu X, Groves FD, McLaughlin CC, Jemal A, Martin JA, Chen VW. Cancer incidence patterns among adolescents and young adults in the United States. Cancer Causes Control. 2005;16(3):309-20.
18. Williams CKO. Some biological and epidemiological characteristics of human leukaemias in Africans. In: Virus-associated cancers in Africa. Lynn: International Agency for Cancer Research; 1985. p. 1-4.
19. Anderson, RE, Ischida K, Li Y, Ishimaru T, Nishiyama H. Geographical aspects of malignant lymphoma and multiple myeloma: selected comparisons involving Japan, England and United States. Am J Pathol 1970;61(1):85-98.
20. Ferra C, Marcos P, Misis M, Morgades M, Bordeje ML, Oriol A, et al. Outcome and prognostic factors in patients with haematologic malignancies admitted to the intensive care unit: a single -centre experience. Int J Haematol 2007;85(3):195-202.
21. Kulkarni KP, Arora RS, Marwaha RK. Survival outcome of childhood acute lymphoblastic leukemia in India: a resource-limited perspective of more than 40 years. J Pediatr Hematol Oncol 2011;33(6):475-9.
22. Pulte D, Redaniel MT, Jansen L, Brenner H, Jeffreys M. Recent Trends In Survival Of Adult Patients With Acute Leukemia: Overall Improvements, But Persistent And Partly Increasing Disparity In Survival Of Patients From Minority Groups. Haematologica 2013;98(2):222-9.
23. Van Maele-Fabry G, Duhayon S, Lison D. A systemic review of myeloid leukemia and occupational pesticide exposure. Cancer Causes Control. 2007; 18(5): 457-78.
Published
2016-08-24
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