Pre-deposit autologous blood donation as a tool for reducing risks associated with allogeneic blood transfusion in Nigeria: is it worth nurturing?

Background: Pre-deposit autologous blood donation (PAD) wherein patient's own blood is collected over a period of time in the lead up to a planned transfusion to the same patient may be a viable alternative to reducing the known and unknown risks often associated with allogeneic blood.Objectives: To assess the practice of pre-deposit autologous blood donation at a hospital-based blood bank unit in north central Nigeria over a four year period.Materials and method: This cross sectional study retrospectively assessed blood transfusion documents and records at the blood bank unit of Federal Medical Centre, Makurdi from 2009 to 2012. Information on predeposit autologous and allogeneic blood donations, types of blood donors and components or products utilized from the records and documents were analysed for proportions using Microsoft Excel and manual methods.Results: Pre-deposit autologous blood donation was generally low ( average 0.40%) and showed a gradual decline over the years; 0.79, 0.31, 0.27 and 0.21 percent in comparison with allogeneic blood donation (76.71, 78.21, 84.76 and 80.36%) average 80.02% and 22.50, 21.49, 14.95 and 19.44 average 19.60% for family replacement and VNRBDs respectively in the years 2009, 2010, 2011 and 2012 respectively. Whole blood and packed red cells transfusions were the predominant blood products utilized over the years with 96.64, 99.04, 97.83 and 98.18% (average 98.32) transfusedas whole blood while 2.57, 0.65, 1.90 and 1.61% (average 1.68%) was transfused as packed cells respectively. All the pre-deposit autologous donations and over 95% of all allogeneic blood donations were transfused as whole blood over the study period.Conclusion: Pre-deposit autologous blood donation is hardly practiced in a setting of high risk and unsafe allogeneic blood due to inadequate implementation of practice guidelines by practitioners.Recommendation: Further researches are needed to improve the overall safety of pre-deposit autologous blood donation especially in a weakened centrally controlled blood system existent in Nigeria. It may be pertinent to provide adequate knowledge, reassess and develop existing guidelines for the practice of PAD in Nigeria.Keywords: Pre-deposit autologous donation; allogeneic blood donation; hospital blood bank; northcentral Nigeri

Multiple myeloma in Nigeria: a multi-centre epidemiological and biomedical study

Introduction: Myelomatosis is a malignant proliferation of plasma cells in the bone marrow, with  relatively high prevalence in African populations. Variation in genetic mutations has been observed in individual patients and may be responsible for differences in disease pattern and treatment outcomes. This study described the presentations and treatment outcomes of multiple myeloma in nigerian. Methods: The data was obtained retrospectively from the case notes of 135 patients diagnosed with multiple myeloma from eight tertiary health institutions across the six geopolitical zones of Nigeria from 2005 to 2014. Data analysis was carried out using SPSS 17.0.Results: The predominant presentations were bone pain in 97 (74%), nephropathy in 47 (35.9%) and pathological fractures in 58 (44.3%). Sixty-seven percent (67%) of the patients were less than 60 years, and 35% had Bence Jones proteinuria. The overall survival beyond 6 months was 91.3%, mean duration of survival rate was 7.4 months. Majority (66.2%) were on Melphalan alone or on melphalan-containing combinations. A higher packed cell volume (PCV) and total serum protein levels at presentation were associated with increased survival, p=0.033 and 0.036, respectively.Conclusion: This study portrayed the importance of detail investigation on the causes of bone pain and anaemia in person's aged 40 years and above. There is a high prevalence of nephropathy in this cohort of patients which needs to be further investigated. Majority of the patients, though < 65 years of age were placed on melphalan-containing combinations, which foreclosed chances of future autologous bone marrow transplantation.Key words: Multiple myeloma, Nigeria, presentation, treatment modalitie