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Hematological malignancies in East Africa-Which cancers to expect and how to provide services.

东非血液恶性肿瘤-预计哪些癌症以及如何提供服务。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0232848
  • 作者列表:"Leak SA","Mmbaga LG","Mkwizu EW","Mapendo PJ","Henke O
  • 发表时间:2020-05-06
Abstract

BACKGROUND:Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to demographic changes, better diagnostic capabilities and life style changes. Kilimanjaro Christian Medical Centre established a Cancer Care Centre (CCC) in December 2016 for a catchment area of 15 million people in Northern Tanzania. This article aims to display the hematological diagnosis and characteristics of the patients as well as to describe the advancements of hematologic services in a low resource setting. METHODS:A cross-sectional analysis of all hematological malignancies at CCC from December 2016 to May 2019 was performed and a narrative report provides information about diagnostic means, treatment and the use of synergies. RESULTS:A total of 209 cases have been documented, the most common malignancies were NHL and MM with 44% and 20%. 36% of NHL cases, 16% of MM cases and 63% of CML cases were seen in patients under the age of 45. When subcategorized, CLL/SLL cases had a median age was 56.5, 51 years for those with other entities of NHL. Sexes were almost equally balanced in all NHL groups while clear male predominance was found in HL and CML. DISCUSSION:Malignancies occur at a younger age and higher stages than in Western countries. It can be assumed that infections play a key role herein. Closing the gap of hematologic services in SSA can be achieved by adapting and reshaping existing infrastructure and partnering with international organizations.

摘要

背景: 撒哈拉以南非洲的非传染性疾病负担日益加重。坦桑尼亚每年的癌症发病率超过35,000,死亡率为80%。血液系统恶性肿瘤占这些病例的10%。由于人口结构的变化、更好的诊断能力和生活方式的改变,这些数字将在未来10年内翻一番。乞力马扎罗山基督教医疗中心于2016年12月为坦桑尼亚北部1500万人的集水区建立了癌症护理中心 (CCC)。本文旨在展示患者的血液学诊断和特征,并描述低资源环境下血液学服务的进展。 方法: 对2016年12月至2019年5月在CCC的所有血液恶性肿瘤进行横断面分析,并提供有关诊断手段,治疗和使用协同作用的叙述性报告。 结果: 共记录了209例病例,最常见的恶性肿瘤是NHL和MM,分别为44% 和20%。36% 的NHL病例、16% 的MM病例和63% 的CML病例见于45岁以下的患者。当进行分类时,CLL/SLL病例的中位年龄为56.5岁,对于患有其他NHL的患者为51岁。在所有NHL组中,性别几乎相等,而在HL和CML中发现明显的男性优势。 讨论: 恶性肿瘤发生在比西方国家更年轻和更高的阶段。可以假设感染在本文中起关键作用。通过调整和重塑现有基础设施并与国际组织合作,可以缩小SSA中血液学服务的差距。

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血液肿瘤方向

常见的血液肿瘤主要包括各类白血病、多发性骨髓瘤以及恶性淋巴瘤。

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