Category: Vol 1, No 4, 2022
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APPRECIATION
The AJLHTS Editorial Board sincerely appreciates all the manuscript reviewers for Volume 1(issue 1,2,3 and 4) 2022
Prof Olutayo I. Ajayi – University of Benin, Nigeria.
Prof Josephine Akpotuzor – University of Calabar, Nigeria.
Dr Nancy Ibeh – Nnamdi Azikiwe University, Awka, Nigeria.
Dr Eze, Evelyn Mgbeoma – Rivers State University, Port Harcourt, Nigeria.
Dr Ben Eledo – Federal Medical Centre, Bayelsa, Nigeria.
Dr Alhaji Bukar – University of Maiduguri, Nigeria.
Dr Marcus Chilaka – University of Bradford, United Kingdom.
Prof. M. A. Muhibi – Edo State University, Uzairue, Nigeria.
Prof. Z.A. Jeremiah – Rivers State University, Port Harcourt, Nigeria.
Dr Rose Amaechi – Ambrose Ali University, Ekpoma, Nigeria.
Dr Okezie Okamgba – Abia State University, Uturu, Nigeria.
Dr Solomon Umukoro – Medical Research Council, The Gambia, West Africa.
Challenges of bone marrow transplant for sickle cell disease in resource limited setting
Chisara Sylvestina Okolo and Ayodeji Olusola Dickson Olayanju
AJLHTS: Original Paper
Summary
Sickle cell disorders (SCD) are a group of inherited disorders that results from both parent being carriers, haemoglobin AS resulting in haemoglobin (SS), causing anemia, infections, pain, stroke, priapism, sequenstration crisis, multiple organ dysfunctions etc. There are several ways of managing sickle cell disorder but the best way, which is considered a gold standard cure for the disease is a successful bone marrow transplant of haematopoietic stem cells (HSCT). Bone marrow (BM), Peripheral blood (PBSC) and Umbilical cord blood (UCB) are rich in stem cells. In order to have a good bone marrow transplant, without graft rejection, the laboratory plays a vital role especially in compatibility testing of donor and recipients at the various stages of the transplant, which includes initial stage, during the transplant and follow up testing to ensure tolerance to the new graft and testing for chimerism. There are various types of transplant which include Autologous, Allogeneic (Sibling/Unrelated Donor), Parent or relative, etc. The various pre transplant tests includes: Sickling test, High Performance Liquid Chromatograph (HPLC), Genetic studies, RBC Indices Hb 6-9 gm/dL, Peripheral Smear, Retic count Reticulocytosis, ESR, Bone marrow analysis. Post-transplant test Includes Engraftment Analysis, Complete Blood counts, kidney function, liver function, Cholesterol, HIV, Hepatitis B, Hepatitis C, additional infectious studies (Endemic testing), Urinalysis etc. Haemopoietic transplantation challenges in a resource limited settings like Nigeria are enormous and they includes: Danger of serious illness associated with donor-to-patient stem cell transplant, lack of appropriate donors, Graft-versus-host disease (GVHD), Inadequate Human resource, Inadequate equipped facility, cost of the service, Corruption, Lack of political will, Leadership incompétence,
‘Chisara Sylvestina Okolo,‘Ayodeji Olusola Dickson Olayanju
strategic planing, Policy inconsistency, Lack of qualified personnel, Poor healthcare administration, Conflict of interest among health workers. The cost of Bone Marrow Transplantation is highly exorbitant to Nigerians and government need to play vital role towards funding part of the cost and alleviating the pain of sickle cell. Effective implementation of National Health Insurance Scheme and address corruption are the most efficient ways the cost would be subsidized. Appropriate information campaigns largely championed by maternal and child health–care professionals would significantly contribute to raising the level of awareness and acceptance of Cord Blood donation. Training and re training of medical personnel cannot be over emphasized.
Some haematological parameters of welders exposed to oxyacetylene in Calabar, Nigeria.
Joyce Ezekiel Etura, Kenneth Igbor Ebi, Uwem Okon Akpan, Enosakhare Aiyudubie Asemota and Anthony Ogbonnaya Emeribe
AJLHTS: Original Paper
Abstract
Introduction: Polymorphonuclear neutrophils (PMN) are the only leucocytes that are competent to produce large amounts of reactive oxygen species (ROS) to kill phagocytized bacteria. In leukaemia, we hypothesized this bactericidal function might be hampered. The goal of this study was to assess respiratory burst activity of PMN in leukaemia compared with non-leukaemic control subjects. We assessed the respiratory burst function of PMN as an effective defence against pathogens in leukaemia and control subjects.
Materials and Methods: Peripheral blood samples were collected from leukaemia and control subjects (30 in each case) in lithium heparin anticoagulant containers. Our study cases were 30 leukaemia belonging to different subtypes (AML=12, CML=12, ALL=4 and CLL=2), 22 males and 8 females age range from 2.5-63 years (M±SEM, 28.0±3.4 years); the controls were 26 males and 4 females, age range from 17-53 years (M±SEM, 31.1±1.5 years), respectively. The respiratory burst activity was assessed using the nitroblue tetrazolium (NBT) dye reduction test on stimulated and un-stimulated PMN in leukaemia and control groups.
Results: The cells purity in leukaemia was >99% using Turk’s solution and cells viability was >95% by Trypan blue dye exclusion test. The respiratory burst activity of PMNs showed a statistically significant increase (P<0.05) in controls compared with leukaemia subtypes. Similarly, comparison within leukaemia subtypes indicates
statistically significant increase (P<0.05) RBA in CML compared with AML, ALL and CLL, respectively.
Conclusion: The respiratory burst activity of PMNs in leukaemia is variable with enhanced activity in CML subjects, while depressed in AML, ALL and CLL subtypes; suggesting impaired bactericidal capacities of PMNs in these diseases.
Respiratory Burst Activities of Peripheral Blood Neutrophils in Leukaemic Subjects in Northern Nigeria
Ajayi, O.l and Danladi S.B.
AJLHTS: Original Paper
Abstract
Introduction: Polymorphonuclear neutrophils (PMN) are the only leucocytes that are competent to produce large amounts of reactive oxygen species (ROS) to kill phagocytized bacteria. In leukaemia, we hypothesized this bactericidal function might be hampered. The goal of this study was to assess respiratory burst activity of PMN in leukaemia compared with non-leukaemic control subjects. We assessed the respiratory burst function of PMN as an effective defence against pathogens in leukaemia and control subjects.
Materials and Methods: Peripheral blood samples were collected from leukaemia and control subjects (30 in each case) in lithium heparin anticoagulant containers. Our study cases were 30 leukaemia belonging to different subtypes (AML=12, CML=12, ALL=4 and CLL=2), 22 males and 8 females age range from 2.5-63 years (M±SEM, 28.0±3.4 years); the controls were 26 males and 4 females, age range from 17-53 years (M±SEM, 31.1±1.5 years), respectively. The respiratory burst activity was assessed using the nitroblue tetrazolium (NBT) dye reduction test on stimulated and un-stimulated PMN in leukaemia and control groups.
Results: The cells purity in leukaemia was >99% using Turk’s solution and cells viability was >95% by Trypan blue dye exclusion test. The respiratory burst activity of PMNs showed a statistically significant increase (P<0.05) in controls compared with leukaemia subtypes. Similarly, comparison within leukaemia subtypes indicates
Ajayi, O.I. and Danladi S.B.
statistically significant increase (P<0.05) RBA in CML compared with AML, ALL and CLL, respectively.
Conclusion: The respiratory burst activity of PMNs in leukaemia is variable with enhanced activity in CML subjects, while depressed in AML, ALL and CLL subtypes; suggesting impaired bactericidal capacities of PMNs in these diseases.
Cyclophosphamide, thalidomide and dexamethasone (CTD) as first-line therapy in multiple myeloma patients: an experience in a clinical haematology centre in Dakar, Senegal
El Hadji Daouda Niang, Fall Seynabou, Sarr Khadim, Camara Marieme Lolita, Dakono Aminata, Ndiaye Awa, Ciss Modou Moustapha, Thiam Amy, and Ndiaye Fatou Samba Diago
AJLHTS: Original Paper
Abstract
Introduction
Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing country setting, in the absence of availability of bone marrow transplantation, the CTD protocol is an accessible treatment regimen whose efficacy and lower toxicity compared to the Melphalan Prednisone protocol has been reported. This protocol has been administered since 2018 in first line at the clinical haematology department of Dalal Jamm Hospital. It’s against this backdrop, that we perform this study to assess the efficacy of this CTD protocol in first line therapy.
Methods
We conducted a descriptive and analytical study including clinical, paraclinical and evolutionary data of 49 patients with MM treated during the period range from 01 September 2018 and 30 November 2021 with the CTD protocol of cyclophosphamide (500mg at D1, D8 and D15), dexamethasone (40mg weekly) and thalidomide (100mg/day) in 28-day cycles. Survival outcomes were estimated by the Kaplan–Meier method.
Results
The mean age was 62.3 ± 9.1 years and the sex ratio was 0.8. An advanced prognostic score at diagnosis was found in 73.5% of patients according to the Salmon and Durie score and in 32% according to the ISS. Overall remission was noted in 48.9%, of which 30.6% were in very good partial remission and partial remission in 12.2% of cases.
Afr J Lab Haem Transf Sci 2022, 1(4): 183 – 189
El Hadji Daouda Niang, Fall Seynabou, Sarr Khadim, Camara Marième Lolita
Progression was noted in 2% of cases. The median survival was 29 months with an overall survival of 78% at 39 months. Treatment- related side effects were mainly peripheral neuropathy in 2% and anaemia in 6%. The median PFS was 27 months with a 72% survival at 39 months. An advanced age (≥ 65 years) is correlated with negative impact on survival (p=0.04).
Conclusion
Cyclophosphamide, thalidomide and dexamethasone give good outcome with less toxicity. Thus, it remains a first-line treatment alternative for newly diagnosed and low–income patients.