Imatinib mesylate in chronic myelogenous leukemia: a Congolese experience

Background: Chronic myeloid leukemia is a clonal myeloproliferative disorder caused by reciprocal translocation t(9;22) that induces tyrosin kinase protein. Imatinib is a selective inhibitor of this protein.Objectives: To assess responses to imatinib and outcome of Congolese patients with chronic phase chronic myeloid leukemia.Design: retrospective study.Settings: Clinical Haematology unit of Teaching Hospital in Brazzaville, CongoSubjects: Newly diagnosed patients with chronic phase chronic myeloid leukemia treated with imatinib.Results: A total of 25 males and 14 females with a mean age of 36 years at time of the diagnosis were enrolled in the study. The mean duration of the illness was 11.4 months. Imatinib induced complete hematologic response at 3 months in 100%. Major cytogenetic response was noticed in 87.18%. After a median follow up of 12 months, chronic myeloid leukemia had not progressed to the accelerated or blastic phase in an estimated 91.8% of patients and 86.6% were alive.Conclusion: Imatinib is effective in newly chronic phase chronic myeloid leukemia patient even though cytogenetic response rate are lower in Africa than western countries population

Clinical profile of children with haemophilia at the University Hospital of Brazzaville

Haemophilia is a rare hereditary haemorrhagic disease caused by coagulation factor VIII (haemophilia A) or IX (haemophilia B) deficiency. Very few data exist on this disease in Congo. This survey aims to describe the epidemiological and clinical aspects of the children affected

African histoplasmosis due to Histoplasma duboisii (Histoplasma capsulatum var. duboisii): fourteen cases observed in Congo during 10 years (1981-1990)

peer reviewedFourteen cases of histoplasmosis due to Histoplasma duboisii seen in Congo from 1981 through 1990, are reported: the average age of the patients was 25 years (the youngest being 1,5 y and the oldest 50y), the M/F ratio was 2,5; most of the patients (10/14) live in a rural area. there was a rather constant frequency of one to three cases per annum from 1981 through 1990. The fisrt congolese AIDS-associated systemic histoplasmosis duboisii case was observed in 1990. Lymph node involvment and mucocutaneous lesions were the most frequent clinical manifestations. In all cases, the disgnosis was established by histological examination. When performed, direct microscopy was always positive (11/11). Isolation of H. duboisii in culture was successful in 7 out of 9 attempts. Two cases of systemic infection were rapidly fatal but a good clinical response was obtained in the other cases wih amphotericin B, which due to intolerance, was replaced by ketoconazole in 2 patients.De 1981 à 1990 nous avons collecté au Congo 14 observations d'histoplasmose à Histoplasma duboisii. Globalement on relève: un sex ratio de 2,5; un âge moyen de 25 ans, avec des extrêmes de 1 an et demi et 50 ans; une majorité de patients (10 sur 14) vivant en milieu rural; une fréquence relativement stable avec de 1 à 3 cas de 1981 à 1990, date à laquelle la première forme diffuse a été observée au cours d'un SIDA. Les atteintes ganglionnaires et cutanéo-muqueuses sont les plus fréquentes. Le diagnsotic a toujours comporté la mise en évidence des levures par l'examen histologique. L'examen direct d'un produit pathologique a été positif dans tous les cas où il a été réalisé (11/11), mais la culture est restée négative à deux reprises. les deux formes disséminées ont été rapidement mortelles. Pour les autres observations l'évolution, à court terme et moyen terme, a toujours été bonne sous amphotéricine B. Dans deux cas, des intolérances ont conduit à prescrire du kétoconazole