Haematology Journal of Bangladesh

Journal Information
ISSN / EISSN : 2523-1219 / 2707-1405
Published by: Haematology Society of Bangladesh (10.37545)
Total articles ≅ 57
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Gazi Yeasinul Islam, Mohiuddin Ahmed Khan, Mafruha Akter, H N Ashiqur Rahman, Ibrahim, Adnan Hasan Masud, Nurul Farhad, A S M Tariqur Rabby
Haematology Journal of Bangladesh, Volume 5, pp 15-19; https://doi.org/10.37545/haematoljbd202062

Abstract:
Background: Induction of acute myeloid leukaemia is associated with a high incidence of treatment related mortality mostly due to neutropenia related infections. This study primarily analyses the duration of neutrophil recovery with or without G-CSF during induction with DA 3+7 in non M3 AML patients. This study also evaluates role of G-CSF in duration febrile neutropenia, hospital stay, total blood products transfusion, total number of used injectable antibiotics and remission status. Methods: It was a Quasi Experimental - Non-Randomized Controlled Trail. There were two groups a) Case = Patients receiving G-CSF b) Control= Patients not receiving G-CSF. Sampling was purposive sampling. Results: 50 patients in two group, G-CSF group (n=25) and Control group (No G-CSF) (n=25) participated in this study. Among them 54% was female and 46% was male. Median age of the participants was 28 years. Neutrophil recovery duration in G-CSF group Vs Control group showed 22.64 Vs 24.64 days (p value 0.003). Duration of febrile neutropenia in G-CSF group Vs Control group showed 11.24 Vs 13.56 days (p value 0.038). Duration of hospital stay in G-CSF group Vs Control group showed 23.64 Vs 25.76 days (p value 0.002). Total number of blood and blood product transfusion in G-CSF group Vs Control group showed 3.80 Vs 3.88 (p value 0.597). Total number of injectable antibiotics in G-CSF group Vs Control group showed 2.72 Vs 3.12 days (p value 0.169). In G-CSF group 22 (88%) and in Control group 23 (92%) were in complete remission (p value 0.637). Conclusions: G-CSF significantly reduces the duration of neutropenia (p value 0.003), febrile neutropenia (p value 0.038) and hospital stay (p value 0.002) after induction with DA 3+7. This may cause reduction in treatment cost and sepsis related mortality. G-CSF can’t significantly reduce use of blood products (p value 0.597) and injectable antibiotics (p value 0.169) after induction with DA 3+7. G-CSF does not affect morphological remission status (p value 0.637) after induction with DA 3+7.
Nurul Farhad, Gazi Yeasinul Islam, Mohammad Wasim, , Tanzia Khanum Tompa
Haematology Journal of Bangladesh, Volume 5, pp 20-26; https://doi.org/10.37545/haematoljbd202169

Abstract:
Background: Hematologic malignancies are of diverse incidence, prognosis, and etiology. Dhaka medical college hospital (DMCH) is a tertiary level hospital and dealing with patients attending from all over the country. We have analyzed data of patients present with hematological malignancy in our Out Patient Department (OPD). As Hematology Dept DMCH deal with patients referred from all over the country, its OPD data represents the picture of whole country. Methods: This is a retro-spective study of OPD patients with hematological malignancy in the department of Hematology of DMCH from January 2018 to December 2018. The diseases were diagnosed on the basis of bone marrow morphology or histopathology (Lymphoma) and or immunophenotyping & molecular genetics. Results: Total 5747 patients were treated in 2018 with the complaints related to hematological malignancy of which 4599 (80%) were old patients and 1148 (20%) were new patients. Among all the treated patients 1420 (24.7%) were female and 4327 (75.3%) were male. Among 1148 new cases 37 were AL(3%), 386 were ALL (34%), 265 were AML(23%), 32 were CLL (3%), 126 were CML (11%), 40 were HL (3%), 18 were MDS (1%), 76 were MM (7%), 168 were NHL (15%). Data shows variation in total number of new patients per month- 83 in January (7.23%), 96 in February (8.36%), 140 in March (12.20%), 98 in April (8.54%), 94 in May (8.19), 89 in June (7.75%), 98 in July (8.54%), 66 in August (5.75%), 99 in September (8.62%), 103 in October (8.97%), 98 in November (8.54%), 84 in December (7.31%) But it does not show any statistical significant frequencies of diseases according to months. Conclusion: We deal a lot of patients with hematological malignancy each year in DMCH. A good portion of them are of ALL because of monthly maintenance of ALL protocols. Analysis of new cases shows ALL, AML, NHL is most common three diseases encounter in OPD. OPD patients’ inflow does not show any significant monthly variation for any of the diseases.
Zulfia Zinat Chowdhury, , Shaila Rahman, Salina Haque, A K M Mynul Islam, Mohammad Ali, Mahbubur Rahman
Haematology Journal of Bangladesh, Volume 5, pp 03-09; https://doi.org/10.37545/haematoljbd202156

Abstract:
Background: Diffuse Large B-Cell Lymphoma (DLBCL), most common Non-Hodgkin Lymphoma (NHL) variety, is an aggressive, fast-growing form comprising up to 40% of all cases globally. Objective: To observe the treatment outcome of different subtypes of Diffuse Large B-Cell Lymphoma (DLBCL) after first-line chemotherapy and also the association with IHC, presenting age, sex, and IPI score with outcome. Methodology: This is a retrospective data analysis included all DLBCL patients registered in the department of Haematology of National Institute of Cancer Research and Hospital (NICRH) between July 2016 to June 2019. Results: Total 188 cases were included in this study and mean age was 48 years with a Standard deviation of 15 years with Male (69.1%) predominance. We divide the cases into three different entities of DLBCL [Germinal Centre B-cell like (GCB), Non-GCB and others (NOS) among them Non-GCB variety was the prevalent (47.3%) one. After first line chemotherapy 52.1% complete remission with 7% death was observed in overall outcome. There was no significant difference in outcome among different types of DLBCL after chemotherapy based on Han’s algorithm. Rituximab with CHOP has significantly better outcome than CHOP alone arm (p: 0.021). Conclusion: This limited database study of NICRH will help to ascertain the outcome of DLBCL after first-line chemotherapy in Bangladesh.
M Morsed Zaman Miah, Abdur Rafi,
Haematology Journal of Bangladesh, Volume 5, pp 10-14; https://doi.org/10.37545/haematoljbd202058

Abstract:
Haemophilia is one of the most common bleeding disorders globally. Though the prevalence of haemophilia in Bangladesh according to the ‘World Haemophilia Registry’ is ten per million people, the original prevalence would be much higher. There is lack of evidence about the socio-demographic and clinical characteristics of these patients. The objective of the present study was characterization of the haemophilia patients according their socio-demographic condition as well as their disease and treatment related profiles. All the patients who visited the haematology department of Rajshahi Medical College Hospital (RMCH) from May 1, 2019 to April 30, 2020 diagnosed as haemophilia were included in the study. Socio-demographic and clinical data from 74 haemophilia patients were analysed. Among them 72 patients were male. More than two-thirds of the patients were from rural area and belonged to lower socioeconomic status. Total 72 out of 74 patients were suffering from haemophilia A. Severity of the disease was mild 34%, moderate 63% and severe 3%. More than 86% patients reported target joint of bleeding and 78% of them had bleeding in last six months. A total of 73% patients received treatment within past six months of the current visit and all of them received factor concentrates. More than 94% patients received treatment on demand. Under the shed of findings of the present study it is recommended that a funded haemophilia management program and optimum use of prophylactic therapy is necessary to improve the quality of life as well as increase life expectancy of the patients.
Quazi Smita Haque, Maruf Al Hasan, Muhammad Shahidul Islam Sikder, Sazzad Zayed Chowdhury, Masba Uddin Chowdhury, Abu Jafar Mohammed Saleh
Haematology Journal of Bangladesh, Volume 5, pp 37-41; https://doi.org/10.37545/haematoljbd202167

Abstract:
Diamond Blackfan Anaemia (DBA) is a rare disorder which presents with anaemia in early childhood. This heterogenous disorder is mainly autosomal dominantly inherited. Significantproportions of the cases are associated with craniofacial anomalies and some cases may end up developing malignancy. The diagnosis is established by blood investigations, and bone marrow studies in which red cell precursors are reduced or absent. Screening for the mutations including those encoding for ribosomal proteins in the patient and the family members is confirmatory for diagnosis. Human Leukocyte Antigen (HLA) matched hemopoietic stem cell transplantation is the definitive treatment of choice. In other cases, corticosteroids have been tried. The haemoglobin level is maintained with packed red cell transfusion. We are presenting here a male baby who had anaemia soon after birth and was brought to us at the age of 1 year 3 months. The diagnosis of DBA was made since the patient presented with anaemia and supportive biochemical and histological evidence. Genetic screening revealed mutation in ribosomal protein S19 (RPS19) gene in the baby.
Sharmin Mafruha, Khaza Amirul Islam, Ishwor Mansingh, Arif-Ur- Rahman, Menoti Paul, Tanjin Tabassum Mitu
Haematology Journal of Bangladesh, Volume 5, pp 42-43; https://doi.org/10.37545/haematoljbd202170

Abstract:
Here we describe a case of 55-year-old lady who was admitted in hospital for evaluation of recurrent anaemia, polyuria and polydipsia with history of splenectomy 9 months back. Physical examination revealed anaemia, dehydration and scar mark of splenectomy. Initial laboratory tests were suggestive of chronic lymphocytic leukaemia (CLL) and further bone marrow examination & immunophenotyping confirmed the diagnosis. At the same time Polyuria & polydipsia was evaluated by water deprivation test and diabetes insipidus was diagnosed.
Akhil Ranjon Biswas, Mahbubur Rahman
Haematology Journal of Bangladesh, Volume 4, pp 52-56; https://doi.org/10.37545/haematoljbd202054

Abstract:
COVID-19 is a cause of life threating severe acute respiratory syndrome (SARS) caused by a novel corona virus named as SARS-Cov-2. Since it has 1st been identified in the city of Wuhan in China in December, 2019, it has spread rapidly all over the world. As it is a newly emerged viral infection and any vaccine or specific therapy yet to be proven as clearly effective, multiple therapeutic option with supportive intent as well as search for specific therapy to combat the virus are under vigorous trial around the world. Convalescent plasma therapy is one such investigational therapeutic option for COVID-19 with hope that neutralizing antibodies present in plasma of persons recovered from COVID-19 would be able to neutralize the virus in infected person.
Muhammad Nurul Farhad, Salma Afrose, Sirajul Islam, Gazi Yeasinul Islam
Haematology Journal of Bangladesh, Volume 4, pp 30-32; https://doi.org/10.37545/haematoljbd202061

Abstract:
Background: Acute leukaemia (AL) is a malignant disorder of the blood that is characterized by blocked or impaired differentiation of haemopoietic stem cells, resulting in abnormal accumulation of immature precursors and suppression of growth and maturation of cells in vivo. Objective: To find out correlation between morphological and immunophenotypic study of bone marrow among acute leukaemia patient. Methods/Procedure: This is a comparative cross sectional study of diagnosis of leukaemia by bone marrow study and immunophenotyping from bone marrow sample with bone marrow alone of suspected cases of leukaemia treated in the department of haematology in Dhaka Medical College Hospital (DMCH)from March 2013 to August 2013 .Bone marrow examination and immunophenotyping was done simultaneously but having bone marrow morphology report we have compared with flow report. Results: Out of 50 patients according to Bone marrow study (BMS) 25(50.0%) of the patients had acute myelogenous leukaemia, 24(48.0%) had acute lymphoblastic leukaemia and 1(2.0%) had acute leukaemia. On the other hand, in immunophenotyping 28(56.0%) patients had acute lymphoblastic leukaemia, 20(40.0%) had acute myelogenous leukaemia and 2(4.0%) mixed cell immunophenotyping. Discordance of diagnosis was found in 3(6%) is diagnose as AML which was ALL on flow and one acute leukaemia and one AML was subsequently diagnose as mixed cellular leukaemia. Conclusion: Subjective variation in the accuracy of diagnosis of leukaemia on the basis of bone marrow study alone may occur. Inclusion of immunophenotyping with bone marrow study improves accuracy of leukaemia.
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