Browsing by Author "Gebray Niguse"

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    Clinical Characteristics and Treatment Outcomes of Patients with Dermatofibrosarcoma Protuberans Treated with Imatinib at Tikur Anbessa Specialized Hospital
    (Addis Abeba University, 2020-12) Gebray Niguse; Gebremedhin Amha
    Background:DFSP is a rare soft tissue tumor with indolent growth and low probability of distant metastasis. More than 90% of cases are positive for CD34 and are characterized by translocation of chromosome 17 and 22 (t (17; 22)) resulting in the expression of fusion gene-COL1A1-PDGFRb. A TKI, imatinib targets this fusion gene and showed efficacy in treating both locally advanced and metastatic DFSP. Objective:The aim of this study is to describe the clinical characteristics of patients and to evaluate response to imatinib of patients with DFSP treated in Tikur Anbessa Hospital. Methods: We assessed retrospectively 26 patients with DFSP treated with imatinib from2004-2020 at hematology unit of Tikur Anbessa Hospital, in Addis Ababa. Clinical data was extracted from medical records and patients and analyzed with SPPS version 26. Response to imatinib was evaluated using Response Evaluation Criteria in Solid Tumors (RECIST). Results:18 of the patients were males and 8 were females with a median age of 35 years (range: 22-66). Trunk is the commonest location of primary tumor constituting 61.5%, followed by head and neck. Twelve patients have been treated with imatinib for locally recurrent disease, which was difficult to resect surgically, and 6 (50%) showed partial response, 3 (25%) complete response, 1 (8.33%) patient had stable disease and 2 (16.67%) had disease progression. On the other hand, thirteen patients underwent surgery for locally recurrent disease followed by imatinib therapy for residual disease. Six (6) of these patients had complete response, 3 patients had partial response and 4 patients had progressive disease while on imatinib. One patient had recurrent disease with liver metastasis and he underwent surgery for local recurrence and imatinib was given for liver metastasis which disappeared after 3 months. The overall clinical response rate was 73.1%. The major adverse effects of imatinib were: GI upset in 38.5%, skin depigmentation in 34.4%, anemia in 23%, leukopenia in 23% and edema in 19.2%, which were all transient and self-limiting. Conclusion: DFSP is highly recurrent tumor after surgical resection. We found out that Imatinib is well tolerated and an effective treatment option for locally recurrent and advanced disease that is difficult for complete surgical resection, with over all clinical response of 73.1%
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    Treatment Outcome of Refractory/Relapsed High-Grade Non- Hodgkin Lymphoma and Classical Hodgkin Lymphoma at Tikur Anbessa Specialized Hospital: A Retrospective Cross-Sectional Study
    (Addis Ababa University, 2023-03) Gebray Niguse; Gebremedhi Amha
    Background: High-dose chemotherapy followed by autologous HSCT is the mainstay of treatment for eligible patients with primary refractory or first relapsed high-gradeNHL and classic Hodgkin’s lymphoma (cHL). In centers where this modality of treatment is not readily available, outcome of salvage chemotherapy alone in this group of patientsis not known. In this single center retrospective study, we evaluated the outcome ofrefractory/relapsed high-grade NHL and cHL treated with salvage chemotherapy alone. Methods: An institution-based cross sectional retrospective study was conducted toreview the outcome of refractory/relapsed lymphomas treated with salvage chemotherapyfrom January 2019 to September 2023 at Tikur Anbessa Specialized Hospital (TASH).Data was collected from HMIS log book and electronic medical records of the patients andanalyzed using SPSS statistical Software. Bivariate and multivariate logistic regressionanalysis was performed to identify the predictors of treatment outcome with 95%confidence interval and p<0.05 being considered as statistically significant. Survivalanalysis was performed using Kaplan-Meir method. Results: A total of 18 cHL (6 refractory and 12 relapsed) and 17 NHL (6 refractoryand 11 relapsed) patients were included in the study. Ten (55.5%) of cHL and 9 (53%) of NHL patients were males and the median age was 29 and 42 years for the cHL and NHLgroups respectively. The main salvage chemotherapy regimens were DHAP (72%) andGDP (28%) for cHL while R-DHAP (50%) and R-GDP (17.6%) for NHL. The ORR tosalvage chemotherapy was significantly better for cHL than NHL group, 77.8% and 52.9%respectively, (p=0.027). The median PFS for cHL and high-grade NHL was 5 and 3months, and the OS rate was 16 and 7 months, respectively. For both histologic groups,primary refractory disease, advanced stage at diagnosis and failure to achieve CR aftersalvage chemotherapy were associated with trend towards inferior OS. Nausea/vomiting and hematologic adverse effects were the main treatment related toxicities in both groups. Conclusion: Three-fourth of patients with RR cHL and half of RR high-grade NHLrespond to salvage chemotherapy alone at our center but the duration of response was not durable and long-term survival was limited. Fund: This study was be funded by Addis Ababa university, College of Health Sciences