COMMON HAEMATOLOGICAL MALIGNANCIES IN NORTHEASTERN NIGERIA: A MULTI-CENTRE STUDY OF THEIR PATTERN, DISTRIBUTION AND TREATMENT CHALLENGES

Rufai Abdu Dachi ^1,2* Falmata Grema Mustapha ² Jasini James ³ Kasim Muhammad Pindiga ⁴ Uchenna Ezenkwa ⁵ Maimuna Orahachi Yusuf ⁶ Saleh Yuguda ⁷ Dauda SULEIMAN ⁸

• ¹ Abubakar Tafawa Balewa University, Bauchi, Nigeria
• ² Department of Haematology and Blood Transfusion, Abubakar Tafawa Balewa University Bauchi, Bauchi, Nigeria
• ³ Department of Haematology and Blood Transfusion, Modibbo Adama Univesrity Yola, Nigeria, Yola, Nigeria
• ⁴ Department of Haematology and Blood Transfusion, Federal Teaching Hospital Gombe, Gombe, Nigeria
• ⁵ Department of Histopathology, Federal University of Health Sciences Azare, Azare, Nigeria
• ⁶ Department of Paediatrics, Federal University of Health Sciences Azare, Azare, Nigeria
• ⁷ Department of Haematology and Blood Transfusion, Gombe State University, Gombe, Gombe, Nigeria
• ⁸ Department of Histopathology, Abubakar Tafawa Balewa University Bauchi, Bauchi, Nigeria

Background: Haematological malignancies (HM) are primary cancers of blood and blood forming organs. They are heterogeneous and of diverse clinical features, treatment protocols and prognosis. They constitute a significant source of cancer related morbidity and mortality. Northeastern Nigeria, being the region in the country with the worst literacy rate and poverty indices is also battling with the burden of these diseases with the limited health facilities to adequately diagnose and treat these ailments. There is paucity of a comprehensive data on HMs in the region, so this study aims to report on the multicenter burden of the common HMs in the region and to discuss their patterns of distribution and management challenges.Materials and Methods: This was a five-year retrospective study where records of cases of HMs diagnosed in the four health facilities viz; Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi, Federal Teaching Hospital (FTH), Gombe, Modibbo Adama University Teaching Hospital (MAUTH), Yola and Federal Medical Centre (FMC), Azare were collected from 1st January, 2018 to 31st December, 2022. Data on the age, gender, diagnosis as well as subtypes of some malignancies were also obtained and analyzed using SPSS Version 23.0 statistical software.Results: Four hundred and ninety-three (493) cases of HMs which constituted 8.2% of all cancers were diagnosed during the period under review. Paediatric HMs constituted 42.0% (207/493) of the HMs. Non-Hodgkin Lymphomas (NHL) constituted the majority of the HM 115/490 (23.5%) while Multiple Myeloma (MM) is the least 38/493 (7.7%). An average cost of 5,000 to 10,000 United State dollars is required to manage a HM in Nigeria. Late presentation of patients, non-availability and inadequate number of personnel, inability to pay for investigations and/or treatments due to financial constraints, limited facilities for tests such as flow cytometry, immunohistochemistry, cytogenetic and molecular genetic analyses were the challenges identified in the institutions in northeastern Nigeria that manage cancer patients.Conclusion: Haematological malignancies are common in our environment and there are limited facilities and expertise to accurately diagnose and treat them in the region and Nigeria in general.