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Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC)

Authors: Mireille Solange Nganga Nkanga, Benjamin Longo-Mbenza, Oladele Vincent Adeniyi, Jacques Bikaula Ngwidiwo, Antoine Lufimbo Katawandja, Paul Roger Beia Kazadi, Alain Nganga Nzonzila

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

The global burden of hematologic malignancy (HM) is rapidly rising with aging, exposure to polluted environments, and global and local climate variability all being well-established conditions of oxidative stress. However, there is currently no information on the extent and predictors of HM at Kinshasa University Clinics (KUC), DR Congo (DRC). This study evaluated the impact of bio-clinical factors, exposure to polluted environments, and interactions between global climate changes (EL Nino and La Nina) and local climate (dry and rainy seasons) on the incidence of HM.

Methods

This hospital-based prospective cohort study was conducted at Kinshasa University Clinics in DR Congo. A total of 105 black African adult patients with anaemia between 2009 and 2016 were included. HM was confirmed by morphological typing according to the French-American-British (FAB) Classification System. Gender, age, exposure to traffic pollution and garages/stations, global climate variability (El Nino and La Nina), and local climate (dry and rainy seasons) were potential independent variables to predict incident HM using Cox regression analysis and Kaplan Meier curves.

Results

Out of the total 105 patients, 63 experienced incident HM, with an incidence rate of 60%. After adjusting for gender, HIV/AIDS, and other bio-clinical factors, the most significant independent predictors of HM were age ≥ 55 years (HR = 2.4; 95% CI 1.4–4.3; P = 0.003), exposure to pollution and garages or stations (HR = 4.9; 95% CI 2–12.1; P < 0.001), combined local dry season + La Nina (HR = 4.6; 95%CI 1.8–11.8; P < 0.001), and combined local dry season + El Nino (HR = 4; 95% CI 1.6–9.7; P = 0.004). HM types included acute myeloid leukaemia (28.6% n = 18), multiple myeloma (22.2% n = 14), myelodysplastic syndromes (15.9% n = 10), chronic myeloid leukaemia (15.9% n = 10), chronic lymphoid leukaemia (9.5% n = 6), and acute lymphoid leukaemia (7.9% n = 5). After adjusting for confounders using Cox regression analysis, age ≥ 55 years, exposure to pollution, combined local dry season + La Nina and combined local dry season + El Nino were the most significant predictors of incident hematologic malignancy.

Conclusion

These findings highlight the importance of aging, pollution, the dry season, El Nino and La Nina as related to global warming as determinants of hematologic malignancies among African patients from Kinshasa, DR Congo. Cancer registries in DRC and other African countries will provide more robust database for future researches on haematological malignancies in the region.
Literature
1.
go back to reference Gopal S, Wood WA, Lee SJ, et al. Meeting the challenge of hematologic malignancies in sub-Saharan Africa. BLOOD; 31 May 2012 Volume 119, No 22. Gopal S, Wood WA, Lee SJ, et al. Meeting the challenge of hematologic malignancies in sub-Saharan Africa. BLOOD; 31 May 2012 Volume 119, No 22.
2.
go back to reference Lichtman MA. Battling hematological malignancies: the 200 years’ war. Oncologist. 2008;13(2):126–38.CrossRefPubMed Lichtman MA. Battling hematological malignancies: the 200 years’ war. Oncologist. 2008;13(2):126–38.CrossRefPubMed
3.
go back to reference Torre LA, Bray F, Siegel RL, et al. Global cancer Statistics, 2013. A cancer journal for clinicians. Volume 65, Issue 2 March/April 2015; p. 87–108. Torre LA, Bray F, Siegel RL, et al. Global cancer Statistics, 2013. A cancer journal for clinicians. Volume 65, Issue 2 March/April 2015; p. 87–108.
4.
go back to reference INSERM. Collective expert reports. A methodological approach for studying the link between cancer and the environment: Cancer; 2005. INSERM. Collective expert reports. A methodological approach for studying the link between cancer and the environment: Cancer; 2005.
5.
go back to reference Hossain MS, Iqbal MS, Khan MA, et al. Diagnosed hematological malignancies in Bangladesh-a retrospective analysis of over 5000 cases from 10 specialized hospitals. BMC Cancer. 2014;14(1):438. Hossain MS, Iqbal MS, Khan MA, et al. Diagnosed hematological malignancies in Bangladesh-a retrospective analysis of over 5000 cases from 10 specialized hospitals. BMC Cancer. 2014;14(1):438.
6.
go back to reference Errahhali ME, Errahhali ME, Boulouiz R, et al. Distribution and features of hematological malignancies in Eastern Morocco: a retrospective multicenter study over 5 years. BMC cancer. 2016;16(1):159. Errahhali ME, Errahhali ME, Boulouiz R, et al. Distribution and features of hematological malignancies in Eastern Morocco: a retrospective multicenter study over 5 years. BMC cancer. 2016;16(1):159.
7.
go back to reference OMS, La fréquence des cancers pourrait augmenter de 50% dans le monde, avec 15 millions de nouveaux cas en 2020. Centre des médias; 2003. OMS, La fréquence des cancers pourrait augmenter de 50% dans le monde, avec 15 millions de nouveaux cas en 2020. Centre des médias; 2003.
8.
go back to reference Mufuta NJP, Mbayo K, Kayembe NZ, et al. Cytologie des hémopathies malignes dans deux formations médicales de Kinshasa /DRCongo Ann. Afr. Med Vol. 6 No 4; 2013. Mufuta NJP, Mbayo K, Kayembe NZ, et al. Cytologie des hémopathies malignes dans deux formations médicales de Kinshasa /DRCongo Ann. Afr. Med Vol. 6 No 4; 2013.
9.
go back to reference Mashinda KD, Kayembe KP, Mapatano MA. Prévalence du cancer en République Démocratique du Congo: données anatomopathologiques recueillies aux Cliniques Universitaires de Kinshasa et à l’Hôpital Général de Référence de Kinshasa Ann. Afr. Med. Vol 6 No 4; 2012. Mashinda KD, Kayembe KP, Mapatano MA. Prévalence du cancer en République Démocratique du Congo: données anatomopathologiques recueillies aux Cliniques Universitaires de Kinshasa et à l’Hôpital Général de Référence de Kinshasa Ann. Afr. Med. Vol 6 No 4; 2012.
10.
go back to reference Diallo DA, Sissoko LS, Sissoko Y, 4 et al. Epidémiologie actuelle des hémopathies malignes dans les services d’hématologie oncologie médicale et de médecine interne de l’hôpital du Point G, Bamako, Mali. Mali Médical; 2005. T XX No 4. Diallo DA, Sissoko LS, Sissoko Y, 4 et al. Epidémiologie actuelle des hémopathies malignes dans les services d’hématologie oncologie médicale et de médecine interne de l’hôpital du Point G, Bamako, Mali. Mali Médical; 2005. T XX No 4.
11.
go back to reference Diagnekpo T, Toutoupo Y, Abissey A, et al. Panorama des hémopathies malignes diagnostiquées au Laboratoire Central du CHU de Treichville Bilan de 10 années d’activités Médecine d’Afrique Noire. 1992; 39(4). Diagnekpo T, Toutoupo Y, Abissey A, et al. Panorama des hémopathies malignes diagnostiquées au Laboratoire Central du CHU de Treichville Bilan de 10 années d’activités Médecine d’Afrique Noire. 1992; 39(4).
12.
go back to reference Mounkaila B, Touré IA, Gragnic GI. Mounkaila Hémopathies malignes à Niamey À propos de 90 observations sur 6 ans Médecine d’Afrique Noire. 1996; 43 (8/9). Mounkaila B, Touré IA, Gragnic GI. Mounkaila Hémopathies malignes à Niamey À propos de 90 observations sur 6 ans Médecine d’Afrique Noire. 1996; 43 (8/9).
13.
go back to reference Fleming AF. Leukemias in Africa. Leukemia. 1993; Vol 7, suppl 2.S138–41. Fleming AF. Leukemias in Africa. Leukemia. 1993; Vol 7, suppl 2.S138–41.
14.
go back to reference Karstaedt AS, Plantanowitz L, Omar T, et al. The utility of bone-marrow examination in HIV-infected adults in South Africa QJ Med 2001; p. 94:101–105. Karstaedt AS, Plantanowitz L, Omar T, et al. The utility of bone-marrow examination in HIV-infected adults in South Africa QJ Med 2001; p. 94:101–105.
15.
go back to reference Longo-Mbenza B, Phanzu-Mbete LB, M'Buyamba-Kabangu JR, et al. Hematocrit and stroke in black Africans under tropical climate and meteorological influence. Ann Med Interne (Paris). 1999; Apr; 150(3):171–7. Longo-Mbenza B, Phanzu-Mbete LB, M'Buyamba-Kabangu JR, et al. Hematocrit and stroke in black Africans under tropical climate and meteorological influence. Ann Med Interne (Paris). 1999; Apr; 150(3):171–7.
16.
go back to reference Kintoki Mbala F, Longo-Mbenza B, Mbungu Fuele S, et al. Impact of seasons, years el Nino/la Nina and rainfalls on stroke-related morbidity and mortality in Kinshasa. Journal des maladies vasculaires Février. 2016;41(1):4–11.CrossRef Kintoki Mbala F, Longo-Mbenza B, Mbungu Fuele S, et al. Impact of seasons, years el Nino/la Nina and rainfalls on stroke-related morbidity and mortality in Kinshasa. Journal des maladies vasculaires Février. 2016;41(1):4–11.CrossRef
17.
go back to reference Chandan, J S. Statistics for Business and Economics. Delhi: Vikas Publishing House, 1998; p. 196–215. Chandan, J S. Statistics for Business and Economics. Delhi: Vikas Publishing House, 1998; p. 196–215.
18.
go back to reference Zhou, G, Minakana, N, Githeko, AK et al. 2005. Climate variability and malaria epidemics in the highlands of East Africa. Trends in parasitology Vol. (21), p. 54-56/ intergovernmental panel on climate change (IPCC), 2007. Annual report. Zhou, G, Minakana, N, Githeko, AK et al. 2005. Climate variability and malaria epidemics in the highlands of East Africa. Trends in parasitology Vol. (21), p. 54-56/ intergovernmental panel on climate change (IPCC), 2007. Annual report.
19.
go back to reference Mantilla G, Oliveros H, Barnston AG. The role of ENSO in understanding changes in Colombia's annual malaria burden by region, 1960–2006. Malaria journal. 2009;8(1):6. Doi:10.1186/1475-2875-8-6. Mantilla G, Oliveros H, Barnston AG. The role of ENSO in understanding changes in Colombia's annual malaria burden by region, 1960–2006. Malaria journal. 2009;8(1):6. Doi:10.​1186/​1475-2875-8-6.
20.
go back to reference Schonfeld SJ, Erdmann F, Wiggill T, et al. Hematologic malignancies in South Africa-2006: analysis of data reported to the National Cancer Registry. Cancer Med. 2016; April 5(4): 728–38. Schonfeld SJ, Erdmann F, Wiggill T, et al. Hematologic malignancies in South Africa-2006: analysis of data reported to the National Cancer Registry. Cancer Med. 2016; April 5(4): 728–38.
21.
go back to reference Omoti CE1, Nwannadi AI1, Obieche JC1, Noma Olu-Eddo A1. The Epidemiological features of lymphoid malignancies in Benin City, Nigeria: A 15 years’ study. The Pan African Medical Journal. 2012; 11:10. Omoti CE1, Nwannadi AI1, Obieche JC1, Noma Olu-Eddo A1. The Epidemiological features of lymphoid malignancies in Benin City, Nigeria: A 15 years’ study. The Pan African Medical Journal. 2012; 11:10.
22.
go back to reference Nwannadi IA, Alao OO, Bazuaye GN, Halim NKD, Omoti CE. The Epidemiology of Haematological Malignancies at the University Of Benin Teaching Hospital: A Ten-Year Retrospective Study. The Internet Journal of Epidemiology. 2010; Volume 9 No 2. Nwannadi IA, Alao OO, Bazuaye GN, Halim NKD, Omoti CE. The Epidemiology of Haematological Malignancies at the University Of Benin Teaching Hospital: A Ten-Year Retrospective Study. The Internet Journal of Epidemiology. 2010; Volume 9 No 2.
23.
go back to reference Patel P, Hanson DL, Sullivan PS, et al. Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003. Ann Intern Med. 2008;148(10):728–36.CrossRefPubMed Patel P, Hanson DL, Sullivan PS, et al. Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003. Ann Intern Med. 2008;148(10):728–36.CrossRefPubMed
24.
go back to reference Engels EA, Pfeiffer RM, Goedert JJ, et al. Trends in cancer risk among people with AIDS in the United States 1980–2002. AIDS. 2006;20(12):1645–54.CrossRefPubMed Engels EA, Pfeiffer RM, Goedert JJ, et al. Trends in cancer risk among people with AIDS in the United States 1980–2002. AIDS. 2006;20(12):1645–54.CrossRefPubMed
25.
go back to reference Grulich AE, van Leeuwen MT. Falster MO, et al incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet. 2007;370(9581):59–67.CrossRefPubMed Grulich AE, van Leeuwen MT. Falster MO, et al incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet. 2007;370(9581):59–67.CrossRefPubMed
26.
go back to reference Mbulaiteye SM, Katabira ET, Wabinga H, et al. Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-cancer registry match study. Int J Cancer. 2006;118(4):985–90.CrossRefPubMed Mbulaiteye SM, Katabira ET, Wabinga H, et al. Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-cancer registry match study. Int J Cancer. 2006;118(4):985–90.CrossRefPubMed
28.
go back to reference Bohlius J, Schmidlin K, Boué F, et al. HIV-1-related Hodgkin lymphoma in the era of combination antiretroviral therapy: incidence and evolution of CD4+ T-cell lymphocytes. Blood. 2011;117(23):6100–8.CrossRefPubMed Bohlius J, Schmidlin K, Boué F, et al. HIV-1-related Hodgkin lymphoma in the era of combination antiretroviral therapy: incidence and evolution of CD4+ T-cell lymphocytes. Blood. 2011;117(23):6100–8.CrossRefPubMed
30.
go back to reference Bonnet F, Burty C, Lewden C, et al. Changes in cancer mortality among HIV-infected patients: the Mortalité 2005 survey. Clin Infect Dis. 2009;48(5):633–9.CrossRefPubMed Bonnet F, Burty C, Lewden C, et al. Changes in cancer mortality among HIV-infected patients: the Mortalité 2005 survey. Clin Infect Dis. 2009;48(5):633–9.CrossRefPubMed
31.
go back to reference Antiretroviral Therapy Cohort Collaboration. Causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996-2006: collaborative analysis of 13 HIV cohort studies. Clin Infect Dis. 2010;50(10):1387–96.CrossRef Antiretroviral Therapy Cohort Collaboration. Causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996-2006: collaborative analysis of 13 HIV cohort studies. Clin Infect Dis. 2010;50(10):1387–96.CrossRef
33.
go back to reference Joint United Nations Program on HIV/AIDS (UNAIDS). Global HIV/AIDS response: progress report 2011. Joint United Nations Program on HIV/AIDS (UNAIDS). Global HIV/AIDS response: progress report 2011.
34.
go back to reference Mwakigonja AR, Kaaya EE, Heiden T, et al. Tanzanian malignant lymphomas: WHO classification, presentation, ploidy, proliferation and HIV/EBV association. BMC Cancer. 2010;10(1):344. Mwakigonja AR, Kaaya EE, Heiden T, et al. Tanzanian malignant lymphomas: WHO classification, presentation, ploidy, proliferation and HIV/EBV association. BMC Cancer. 2010;10(1):344.
35.
go back to reference Naresh KN, Raphael M, Ayers L, et al. Lymphomas in sub-Saharan Africa: what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research? Br J Haematol. 2011;154(6):696–703.CrossRefPubMedPubMedCentral Naresh KN, Raphael M, Ayers L, et al. Lymphomas in sub-Saharan Africa: what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research? Br J Haematol. 2011;154(6):696–703.CrossRefPubMedPubMedCentral
37.
go back to reference Wiggill TM, Mantina H, Willem P, et al. Changing pattern of lymphoma subgroups at a tertiary academic complex in a high prevalence HIV setting: a south African perspective. J Acquir Immune Defic Syndr. 2011;56(5):460–6.CrossRefPubMed Wiggill TM, Mantina H, Willem P, et al. Changing pattern of lymphoma subgroups at a tertiary academic complex in a high prevalence HIV setting: a south African perspective. J Acquir Immune Defic Syndr. 2011;56(5):460–6.CrossRefPubMed
38.
go back to reference Dongre NN, Suryakar AN, Patil AJ, Rathi DB. Occupational lead exposure in automobile workers in North Karnataka (India): effect on liver and kidney functions. Al Ame en J Med Sci. 2010;3(4):284–92. Dongre NN, Suryakar AN, Patil AJ, Rathi DB. Occupational lead exposure in automobile workers in North Karnataka (India): effect on liver and kidney functions. Al Ame en J Med Sci. 2010;3(4):284–92.
39.
go back to reference Natelson EA. Benzene-induced acute myeloid leukemia: a clinician's perspective. Am J Hematol. 2007;82(9):826–30.CrossRefPubMed Natelson EA. Benzene-induced acute myeloid leukemia: a clinician's perspective. Am J Hematol. 2007;82(9):826–30.CrossRefPubMed
40.
go back to reference Jomova K, Valko M. Advances in metal-induced oxidative stress and human disease Toxicology 2011 May 10: 283 (2–3): 65–87. Jomova K, Valko M. Advances in metal-induced oxidative stress and human disease Toxicology 2011 May 10: 283 (2–3): 65–87.
41.
go back to reference Ziello JE, Jovin IS, Huang Y. Hypoxia-Inducible Factor (HIF)-1 Regulatory pathway and its potential for therapeutic intervention in malignancy and ischemia. Yale J Biol Med. 2007; Jun;80(2):51–60.PubMedPubMedCentral Ziello JE, Jovin IS, Huang Y. Hypoxia-Inducible Factor (HIF)-1 Regulatory pathway and its potential for therapeutic intervention in malignancy and ischemia. Yale J Biol Med. 2007; Jun;80(2):51–60.PubMedPubMedCentral
42.
go back to reference Valko M, Morris H, Cronin MT. Metals, toxicity and oxidative stress. Curr Med Chem. 2005;12(10):1161–208.CrossRefPubMed Valko M, Morris H, Cronin MT. Metals, toxicity and oxidative stress. Curr Med Chem. 2005;12(10):1161–208.CrossRefPubMed
43.
44.
go back to reference Buijsse B, Feskens EJ, Moschandreas J, et al. Oxidative stress, and iron and antioxidant status in elderly men: differences between the South Mediterranean (Crete) and northern Europe (Zutphen.). Eur. J. Cardiovasc. Prev. Rehab. 2007;14:495–500.CrossRef Buijsse B, Feskens EJ, Moschandreas J, et al. Oxidative stress, and iron and antioxidant status in elderly men: differences between the South Mediterranean (Crete) and northern Europe (Zutphen.). Eur. J. Cardiovasc. Prev. Rehab. 2007;14:495–500.CrossRef
45.
go back to reference Rericha V, Kulich M, Rericha R, et al. Sandler incidence of leukemia, lymphoma, and multiple myeloma in Czech uranium miners: a case–cohort study. Environ Health Perspect. 2006;114:818–22.CrossRefPubMedPubMedCentral Rericha V, Kulich M, Rericha R, et al. Sandler incidence of leukemia, lymphoma, and multiple myeloma in Czech uranium miners: a case–cohort study. Environ Health Perspect. 2006;114:818–22.CrossRefPubMedPubMedCentral
46.
go back to reference Muz B, de la Puente P, Azab F, et al. The Role of Hypoxia and Exploitation of the Hypoxic Environment in Hematologic Malignancies Mol Cancer Res, 2012; 12(10)1347–1354. Muz B, de la Puente P, Azab F, et al. The Role of Hypoxia and Exploitation of the Hypoxic Environment in Hematologic Malignancies Mol Cancer Res, 2012; 12(10)1347–1354.
47.
go back to reference Lichtman MA, Rowe JM. The relationship of patient age to the pathobiology of the clonal myeloid diseases. Semin Oncol. 2004;31:185–97.CrossRefPubMed Lichtman MA, Rowe JM. The relationship of patient age to the pathobiology of the clonal myeloid diseases. Semin Oncol. 2004;31:185–97.CrossRefPubMed
Metadata
Title
Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC)
Authors
Mireille Solange Nganga Nkanga
Benjamin Longo-Mbenza
Oladele Vincent Adeniyi
Jacques Bikaula Ngwidiwo
Antoine Lufimbo Katawandja
Paul Roger Beia Kazadi
Alain Nganga Nzonzila
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3547-3

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