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N, DRGITHANGAJESSIE.  Submitted.  Co-authored a chapter entitled 'Haematologic manifestations of HIV.' The chapter is contained in the handbook 'Clinical care in times of AIDS.' These are guidelines intended for health workers in rural district hospitals and health centres. The handbook, . Book. : Douglas McLean Publishing Abstract
Catechol O-methyltransferase (COMT) inactivates neurotransmitters, hormones and drugs such as levodopa. COMT activity is inherited in an autosomal recessive manner and individuals with low activity have thermolabile COMT protein. A low activity allele has been demonstrated at codon 108/158 of the soluble and membrane bound COMT protein, respectively, whereby a G to A transition results in a valine to methionine substitution, rendering the protein more thermolabile. As ethnic differences in erythrocyte COMT activity have been previously demonstrated, the frequency of low activity alleles were investigated in 265 British Caucasian, 99 British South-west Asian and 102 Kenyan individuals. Genotyping of COMT codon 108/158 was performed using a minisequencing method. Erythrocyte COMT activity was measured in 60 British Caucasian individuals by radiochemical assay. The frequency of low activity alleles was 0.54 in Caucasians, 0.49 in South-west Asians, and 0.32 in Kenyans. There was a much lower frequency of individuals with homozygous low activity allele in the Kenyan population (9%) than in Caucasians (31%) or South-west Asians (27%). Erythrocyte COMT activity was lower and less thermostable in individuals with homozygous low activity alleles. The data provide molecular evidence that low COMT is less common in African individuals than the Caucasian population. PMID: 9682265 [PubMed - indexed for MEDLINE]
N, DRGITHANGAJESSIE.  Submitted.  Master of Medicine (in Pathology) dissertation entitled "Chromosomal abnormalities in childhood acute leukaemia at K.N.H., Nairobi, Kenya.". Book. : Douglas McLean Publishing Abstract
Catechol O-methyltransferase (COMT) inactivates neurotransmitters, hormones and drugs such as levodopa. COMT activity is inherited in an autosomal recessive manner and individuals with low activity have thermolabile COMT protein. A low activity allele has been demonstrated at codon 108/158 of the soluble and membrane bound COMT protein, respectively, whereby a G to A transition results in a valine to methionine substitution, rendering the protein more thermolabile. As ethnic differences in erythrocyte COMT activity have been previously demonstrated, the frequency of low activity alleles were investigated in 265 British Caucasian, 99 British South-west Asian and 102 Kenyan individuals. Genotyping of COMT codon 108/158 was performed using a minisequencing method. Erythrocyte COMT activity was measured in 60 British Caucasian individuals by radiochemical assay. The frequency of low activity alleles was 0.54 in Caucasians, 0.49 in South-west Asians, and 0.32 in Kenyans. There was a much lower frequency of individuals with homozygous low activity allele in the Kenyan population (9%) than in Caucasians (31%) or South-west Asians (27%). Erythrocyte COMT activity was lower and less thermostable in individuals with homozygous low activity alleles. The data provide molecular evidence that low COMT is less common in African individuals than the Caucasian population. PMID: 9682265 [PubMed - indexed for MEDLINE]

2013

Githanga, J, Axt J, Abdallah F, Axt M, Hansen E, et al.  2013.  Wilms Tumor Survival in Kenya. National institute of health. 48(6)(2013 June ):1254–1262.wilms_paper_githanga__abdalla.pdf

2012

Lang'o, MO, Githanga JN, Yuko-jowi CA.  2012.  Prevalence Of Iron Deficiency In Children With Cyanotic Heart Disease Seen At Kenyatta National Hospital And Mater Hospital Nairobi. Abstract

To establish the prevalence of iron deficiency among children with cyanotic heart disease. DESIGN: Cross-sectional study. SETTING: The study was carried out at Kenyatta National Hospital and Mater Hospital from August to December of 2007. A total of 112 children meeting the eligibility criteria were recruited from the wards and the cardiac clinics. SUBJECTS: These were children less than 18 years of age, with cyanotic heart disease confirmed on ECHO, presenting at the paediatric cardiac clinic of the two hospitals or admitted in the wards at Kenyatta National Hospital. These were patients who had not undergone surgical correction. RESULTS: The prevalence of iron deficiency was found to be 16.9% (95% CI 9.8-24.1%). CONCLUSION: There is a high prevalence of iron deficiency among patients with congenital heart disease with cyanosis in the two institutions. Routine screening for iron deficiency is recommended for these children and those found to be deficient should be treated.

Shiroya-Wandabwa, M, Yuko-Jowi C, R W Nduati, Githanga J, Wamalwa D.  2012.  Risk factors for cardiac dysfunction in children on treatment for cancer at Kenyatta National Hospital, Nairobi. Abstract

To determine the point prevalence of abnormal cardiac function and to assess the risk factors for cardiac dysfunction in paediatric oncology patients on treatment at Kenyatta National Hospital. DESIGN: Descriptive cross-sectional study with a nested case control. SETTING: Kenyatta National Hospital between February and April 2006. MAIN OUTCOME MEASURES: Left ventricular dysfunction if ejection fraction (EF) <55% or fractional shortening (FS) <29% defined cases. Controls had EF >55% or FS >29%. RESULTS: One hundred and eleven patients were enrolled of whom 32 had abnormal cardiac function and were classified as cases while 79 had normal cardiac function. About a third, point prevalence 29% (95% CI 21.2-37.9), had cardiac dysfunction. Cumulative anthracycline dose was a risk factor for cardiac dysfunction in this population. Above 200 mg/m2 the attributable risk percentage of cardiac dysfunction was 77%. CONCLUSIONS: Serial echocardiography should be performed to identify patients at risk. Alternative treatment protocols should be used when the cumulative anthracycline dose exceeds 200 mg/m2 due to the high attributable risk. Studies to further assess the other associated risk factors and long term effects of anthracycline are recommended.

Rajab, JA, Ngoma T, Adde M, Durosinmi M, Githang'a J, Aken'Ova Y, Kaijage J, Adeodou O, Brown BJ, Leoncini L, Naresh K, Raphael M, Hurwitz N, Scanlan P, Rohatiner A, Venzon D, Magrath I.  2012.  Treatment of Burkitt lymphoma in equatorial Africa using a simple three-drug combination followed by a salvage regimen for patients with persistent or recurrent disease. Abstract

Prior to the introduction of the International Network for Cancer Treatment and Research (INCTR) protocol INCTR 03-06, survival of patients with Burkitt lymphoma at four tertiary care centres in equatorial Africa was probably no more than 10-20%. The results reported here for 356 patients have demonstrated marked improvement in survival through the use of a uniform treatment protocol consisting of cyclophosphamide, methotrexate, vincristine, and intrathecal therapy, and the introduction of non-cross resistant second-line (salvage) therapy, consisting of ifosfamide, mesna, etoposide and cytarabine, when patients failed to achieve a complete response to first-line therapy or relapsed early. Overall survival rates of 67% and 62% were observed at 1 and 2 years (relapse is rare after 1 year of remission). Of interest was the small impact of cerebrospinal fluid (CSF) and bone marrow involvement on outcome. However, the presence or absence of abdominal involvement clearly defined two prognostic groups. An additional finding was the association between CSF pleocytosis and orbital tumours, suggesting that spread of tumour cells to the central nervous system may sometimes occur via direct involvement of cranial nerves in the orbit. Survival rates may be increased in patients with abdominal involvement by combining first- and second-line therapy, but verification will require a further clinical study.

2005

N, DRGITHANGAJESSIE.  2005.  Maxwell TJ, Ameyaw MM, Pritchard S, Thornton N, Folayan G, Githang'a J, Indalo A, Tariq M, Mobarek A, Evans DA, Ofori-Adjei D, Templeton AR, McLeod HL. Int J Mol Med. 2005 Oct;16(4):573-80. Beta-2 adrenergic receptor genotypes and haplotypes in different . Int J Mol Med. 2005 Oct;16(4):573-80.. : Douglas McLean Publishing Abstract
The human beta-2 adrenergic receptor (beta2AR) is responsible for the binding of endogenous catecholamines and their exogenously administered agonists and antagonists. Three functional polymorphisms in codons 16, 27 and 164 have been described which have clinical importance for several diseases, including asthma, hypertension, heart failure, cystic fibrosis and obesity, as well as response to beta-agonist therapy. These were evaluated in 726 individuals from 8 distinct ethnic populations (Chinese, Filipino, Southwest Asian, Saudi, Ghanaian, Kenyan, Sudanese, and European from Scotland). The results show that most haplotypes are shared among all populations, yet there are marked differences in their frequency distributions geographically. The genetic distance tree is different from standard human population distance trees, implying a different mode of evolution for this locus than that for human population gene-flow history. The multilocus frequency differences between the observed clusters of populations correspond to historical haplotype groupings that have been found to be functionally different with respect to multiple medically related phenotypes. Further studies are needed to see if functional relationships are the same across populations.

2001

N, DRGITHANGAJESSIE.  2001.  Githang'a JN, Dave P. Bone marrow examination at a paediatric hospital in Kenya. East Afr Med J. 2001 Jul;78(7 Suppl):S37-9.. Pharmacogenetics. 2001 Apr;11(3):217-21.. : Douglas McLean Publishing Abstract
OBJECTIVE: To investigate the main indications for, and common conditions found in bone marrow examinations (BME) of children. METHODS: This was a retrospective study from September 1, 1993 to September 3 1998. All bone marrow aspirate and trephine biopsy results were retrieved. The clinical data provided by clinicians were also noted. RESULTS: A total of 97 BME were recorded from patients aged two months to 13 years. The peak ages for BME were six to eight years (24% of patients). The more frequent indications for BME were unexplained anaemia found in 26% request forms, investigation for solid tumours (10%) and lymphoma (10%) and remission assessment after treatment for leukaemia (26%). The main findings were malignancy (27%) with leukaemia being commonest (ALL) 16% of patients and acute myeloblastic leukaemia (5%). Haematinic deficiency was seen in 12.7% of cases with iron deficiency being the commonest. There were some notable differences and similarities in the study as compared to a similar one performed at a local referral hospital. CONCLUSION: The importance of BME as a crucial investigational tool in the management of patients is underscored. Interpretation is more meaningful when the haematologist has adequate clinical data.
N, DRGITHANGAJESSIE.  2001.  Githang. East Afr Med J. 2001 Jul;78(7 Suppl):S37-9.. : Douglas McLean Publishing Abstract
Department of Haematology, College of Health Sciences, University of Nairobi. OBJECTIVE: To investigate the main indications for, and common conditions found in bone marrow examinations (BME) of children. METHODS: This was a retrospective study from September 1, 1993 to September 3 1998. All bone marrow aspirate and trephine biopsy results were retrieved. The clinical data provided by clinicians were also noted. RESULTS: A total of 97 BME were recorded from patients aged two months to 13 years. The peak ages for BME were six to eight years (24% of patients). The more frequent indications for BME were unexplained anaemia found in 26% request forms, investigation for solid tumours (10%) and lymphoma (10%) and remission assessment after treatment for leukaemia (26%). The main findings were malignancy (27%) with leukaemia being commonest (ALL) 16% of patients and acute myeloblastic leukaemia (5%). Haematinic deficiency was seen in 12.7% of cases with iron deficiency being the commonest. There were some notable differences and similarities in the study as compared to a similar one performed at a local referral hospital. CONCLUSION: The importance of BME as a crucial investigational tool in the management of patients is underscored. Interpretation is more meaningful when the haematologist has adequate clinical data.
N, DRGITHANGAJESSIE.  2001.  Ameyaw MM, Regateiro F, Li T, Liu X, Tariq M, Mobarek A, Thornton N, Folayan GO, Githang'a J, Indalo A, Ofori-Adjei D, Price-Evans DA, McLeod HL..MDR1 pharmacogenetics: frequency of the C3435T mutation in exon 26 is significantly influenced by ethnicity. . Pharmacogenetics. 2001 Apr;11(3):217-21.. : Douglas McLean Publishing Abstract
P-glycoprotein (PGP), the product of the multidrug resistance gene (MDR1), acts as an energy-dependent efflux pump that exports its substrates out of the cell. PGP expression is an important factor regulating absorption of a wide variety of medications. It has also been associated with intrinsic and acquired cross resistance to a number of structurally unrelated anticancer drugs. A single nucleotide polymorphism (SNP) in exon 26 of the MDR1 gene, C3435T, was recently correlated with PGP protein levels and substrate uptake. Individuals homozygous for the T allele have more than four-fold lower PGP expression compared with CC individuals. As overexpression of PGP has been associated with altered drug absorption, therapy-resistant malignancies, and lower concentrations of HIV-1 protease inhibitors, this SNP may provide a useful approach to individualize therapy. To facilitate clinical application throughout the world, 1280 subjects from 10 different ethnic groups were evaluated for this SNP using the polymerase chain reaction-restriction fragment length polymorphism assay and the genotype and allele frequency for each group were ascertained. Marked differences in genotype and allele frequency were apparent between the African populations and the Caucasian/Asian populations (P < 0.0001). The Ghanaian, Kenyan, African American and Sudanese populations studied had frequencies of 83%, 83%, 84% and 73%, respectively, for the C allele. The British Caucasian, Portuguese, South-west Asian, Chinese, Filipino and Saudi populations had lower frequencies of the C allele compared to the African group (48%, 43%, 34%, 53%, 59%, and 55%, respectively). The high frequency of the C allele in the African group implies overexpression of PGP and may have important therapeutic and prognostic implications for use of PGP dependent drugs in individuals of African origin. PMID: 11337937 [PubMed - indexed for MEDLINE]

2000

N, DRGITHANGAJESSIE.  2000.  Morsman JM, Sludden J, Ameyaw MM, Githang'A J, Indalo A, Ofori-Adjei D, McLeod HL.Evaluation of dihydropyrimidine dehydrogenase activity in South-west Asian, Kenyan and Ghanaian populations. Br J Clin Pharmacol. 2000 Sep;50(3):269-72.. Br J Clin Pharmacol. 2000 Sep;50(3):269-72.. : Douglas McLean Publishing Abstract

AIMS: Dihydropyrimidine dehydrogenase (DPD) reduces endogenous pyrimidines and therapeutic analogues such as the anticancer agent 5-fluorouracil (5FU). Among Caucasian populations DPD activity is highly variable and subject to polymorphic regulation. To evaluate interethnic influence, DPD activity was assessed in South-west Asian, Kenyan and Ghanaian populations. METHODS: DPD activity was determined in peripheral mononuclear cells using[14C]-5-fluorouracil and h.p.l.c. analysis. RESULTS: A high degree of variation in DPD activity was observed within each population (range CV = 34-48%). Median DPD activity also varied between these populations. South-west Asian and Kenyan subjects exhibited almost identical median values (192 and 193.5 pmol min(-1) mg(-1), respectively), which were similar to Caucasians (median 215 pmol min(-1) mg(-1). A significantly lower median DPD activity (119 pmol min(-1) mg(-1)) was observed in the Ghanaian population. CONCLUSIONS: The similarity in DPD activity between Caucasian, Kenyan and South-west Asian populations suggests that the incidence of 5FU-related toxicity may be comparable in these groups. The pharmacokinetic implications of lower activity amongst Ghanaians needs to be evaluated.

N, DRGITHANGAJESSIE.  2000.  Marsh S, Ameyaw MM, Githang'a J, Indalo A, Ofori-Adjei D, McLeod HL.Novel thymidylate synthase enhancer region alleles in African populations. Hum Mutat. 2000 Dec;16(6):528.. Hum Mutat. 2000 Dec;16(6):528.. : Douglas McLean Publishing Abstract
Thymidylate synthase (TS) regulates the production of DNA synthesis precursors and is an important target of cancer chemotherapy. A polymorphic tandem repeat sequence in the enhancer region of the TS promoter was previously described, where the triple repeat gives higher in vitro gene expression than a double repeat. We recently identified ethnic differences in allele frequencies between Caucasian and Asian populations. We now describe assessment of genotype and allele frequencies of the TS polymorphism in 640 African (African American, Ghanaian and Kenyan) and Caucasian (UK, USA) subjects. The double and triple repeat were the predominant alleles in all populations studied. The frequency of the triple repeat allele was similar between Kenyan (49%), Ghanaian (56%), African American (52%), American Caucasian (54%) and British Caucasian (54%) subjects. However, two novel alleles contained 4 and 9 copies of the tandem repeat. These novel alleles were found at a higher allele frequency in African populations (Kenyan 7%, Ghanaian 3%, African American 2%) than Caucasians (UK 1%, USA 0%). The novel alleles identified in this study decrease in frequency with Western migration, while the common alleles are relatively stable. This is a unique example suggesting the influence of multiple selection pressures within individual populations. Hum Mutat 16:528, 2000. Copyright 2000 Wiley-Liss, Inc.
N, DRGITHANGAJESSIE.  2000.  Morsman, JM., Sludden, J., Ameyaw, M-M., Githang'a, J., Indalo, A.., Ofori-Adjei, D., McLeod, H.L. (2000) Evaluation of dihydropyrimidine dehydrogenase activity in Southwest Asian, Kenyan and Ghanaian populations. Br J Clin Pharm 50:269. Pharmacogenetics. 2001 Apr;11(3):217-21.. : Douglas McLean Publishing Abstract
OBJECTIVE: To investigate the main indications for, and common conditions found in bone marrow examinations (BME) of children. METHODS: This was a retrospective study from September 1, 1993 to September 3 1998. All bone marrow aspirate and trephine biopsy results were retrieved. The clinical data provided by clinicians were also noted. RESULTS: A total of 97 BME were recorded from patients aged two months to 13 years. The peak ages for BME were six to eight years (24% of patients). The more frequent indications for BME were unexplained anaemia found in 26% request forms, investigation for solid tumours (10%) and lymphoma (10%) and remission assessment after treatment for leukaemia (26%). The main findings were malignancy (27%) with leukaemia being commonest (ALL) 16% of patients and acute myeloblastic leukaemia (5%). Haematinic deficiency was seen in 12.7% of cases with iron deficiency being the commonest. There were some notable differences and similarities in the study as compared to a similar one performed at a local referral hospital. CONCLUSION: The importance of BME as a crucial investigational tool in the management of patients is underscored. Interpretation is more meaningful when the haematologist has adequate clinical data.

1999

N, DRGITHANGAJESSIE.  1999.  McLeod HL, Pritchard SC, Githang'a J, Indalo A, Ameyaw MM, Powrie RH, Booth L, Collie-Duguid ES..Ethnic differences in thiopurine methyltransferase pharmacogenetics: evidence for allele specificity in Caucasian and Kenyan individuals.Pharmacogenetics. 199. Pharmacogenetics. 1999 Dec;9(6):773-6.. : Douglas McLean Publishing Abstract
Thiopurine methyltransferase (TPMT) degrades 6-mercaptopurine, azathioprine and 6-thioguanine which are commonly used in the treatment of autoimmune diseases, leukaemia and organ transplantation. TPMT activity is polymorphic as a result of gene mutations. Heterozygous individuals have an increased risk of haematological toxicity after thiopurine medication, while homozygous mutant individuals suffer life threatening complications. Previous population studies have identified ethnic variations in both phenotype and genotype, but limited information is available within African populations. This study determined the frequency of common TPMT variant alleles in 101 Kenyan individuals and 199 Caucasians. The frequency of mutant alleles was similar between the Caucasian (10.1%) and Kenyan (10.9%) populations. However, all mutant alleles in the Kenyan population were TPMT*3C compared with 4.8% in Caucasians. In contrast TPMT*3A was the most common mutant allele in the Caucasian individuals. This study confirms ethnic differences in the predominant mutant TPMT allele and the findings will be useful for the development of polymerase chain reaction-based strategies to prevent toxicity with thiopurine medications. PMID: 10634140 [PubMed - indexed for MEDLINE]
N, DRGITHANGAJESSIE.  1999.  McLeod, H. L., Pritchard S. C., Githang'a J., et al. (1999). Ethnic differences in thiopurine methyltransferase pharmacogenetics: evidence for allele specificity in Caucasian and Kenyan subjects. Pharmacogenetics 9: 773-776. Book. : Douglas McLean Publishing Abstract
AIMS: Dihydropyrimidine dehydrogenase (DPD) reduces endogenous pyrimidines and therapeutic analogues such as the anticancer agent 5-fluorouracil (5FU). Among Caucasian populations DPD activity is highly variable and subject to polymorphic regulation. To evaluate interethnic influence, DPD activity was assessed in South-west Asian, Kenyan and Ghanaian populations. METHODS: DPD activity was determined in peripheral mononuclear cells using[14C]-5-fluorouracil and h.p.l.c. analysis. RESULTS: A high degree of variation in DPD activity was observed within each population (range CV = 34-48%). Median DPD activity also varied between these populations. South-west Asian and Kenyan subjects exhibited almost identical median values (192 and 193.5 pmol min(-1) mg(-1), respectively), which were similar to Caucasians (median 215 pmol min(-1) mg(-1). A significantly lower median DPD activity (119 pmol min(-1) mg(-1)) was observed in the Ghanaian population. CONCLUSIONS: The similarity in DPD activity between Caucasian, Kenyan and South-west Asian populations suggests that the incidence of 5FU-related toxicity may be comparable in these groups. The pharmacokinetic implications of lower activity amongst Ghanaians needs to be evaluated.

1998

N, DRGITHANGAJESSIE, N DRGITHANGAJESSIE.  1998.  McLeod HL, Syv. Pharmacogenetics. 1998 Jun;8(3):195-9.. : Douglas McLean Publishing Abstract
Catechol O-methyltransferase (COMT) inactivates neurotransmitters, hormones and drugs such as levodopa. COMT activity is inherited in an autosomal recessive manner and individuals with low activity have thermolabile COMT protein. A low activity allele has been demonstrated at codon 108/158 of the soluble and membrane bound COMT protein, respectively, whereby a G to A transition results in a valine to methionine substitution, rendering the protein more thermolabile. As ethnic differences in erythrocyte COMT activity have been previously demonstrated, the frequency of low activity alleles were investigated in 265 British Caucasian, 99 British South-west Asian and 102 Kenyan individuals. Genotyping of COMT codon 108/158 was performed using a minisequencing method. Erythrocyte COMT activity was measured in 60 British Caucasian individuals by radiochemical assay. The frequency of low activity alleles was 0.54 in Caucasians, 0.49 in South-west Asians, and 0.32 in Kenyans. There was a much lower frequency of individuals with homozygous low activity allele in the Kenyan population (9%) than in Caucasians (31%) or South-west Asians (27%). Erythrocyte COMT activity was lower and less thermostable in individuals with homozygous low activity alleles. The data provide molecular evidence that low COMT is less common in African individuals than the Caucasian population. PMID: 9682265 [PubMed - indexed for MEDLINE]
N, DRGITHANGAJESSIE.  1998.  Githang'a, J. N. (1998). Diagnosis of disseminated alveolar rhabdomyosarcoma using cytogenetics: case report.. East Afr Med J. 1998 Dec;75(12):724-5.. : Douglas McLean Publishing Abstract
Department of Haematology and Blood Transfusion, College of Health Sciences, University of Nairobi, Kenya. The clinical, histologic and cytogenetic features of a patient with the alveolar subtype of rhabdomyosarcoma (RMS) were investigated. The patient presented with a widely disseminated tumour including bone marrow involvement, and was a diagnostic dilemma. The presence of translocation (2;13)(q37;q14), which is strongly associated with alveolar RMS helped make the diagnosis. A review of other published cases confirms the strong association of (2;13) with alveolar RMS. The importance of considering RMS as a differential diagnosis in patients presenting with disseminated tumour as the only finding is stressed. This case also shows how cytogenetic investigation of similar patients may provide a diagnosis.

1985

Githang'a, JN.  1985.  Chromosomal Abnormalities In Childhood Acute Leukaemia At Kenyatta National Hospital, Nairobi. Abstract

This is a prospective study of 14 patients aged from
ten months to 13 years admitted to KNH with acute leukaemia
(AL). Chromosomal analysis was successfully performed in
nine children. The clinical and laboratory features of the
patients were also analysed in relation to cytogenetic
abnormalities identified.
The study revealed that eight out of 14 (57!1~) of the
patients had acute non-lymphocytic leukaemia (ANLL) and 43%
had acute lymphoblastic leukaemia (ALL). Out of the five
children with ANLL who had chromosomal analysis performed
three (60%) had karyotype abnormal it i es: two pat i en ts had
hyperdiploidy, one with AML M5a had 47 chromosomes, and the
other with AML M2 had trisomy 21; the third patient had
monosomy 7. None of the four patients with ALL who had
chromosomal analysis performed had any karyotype
abnormalities.
Four out of the nine patients, whose karyotypes were
determined, died. All the four had normal karyotypes . Two
died of haemorrhage having had platelet counts less than 20
x 109/1 which is a poor prognostic feature. The other two
died of overwhelming infections.
Surface marker studies done during the course of the
study were helpful in making a final
complemented the morphological diagnosis.
diagnosis and

Evidence from the study shows that karyotypic
abnormalities in ANLL occur as frequently as those found in
other studies. The prognostic significance of the
chromosomal abnormalities has not been clearly demonstrated
in this study in view of the sample size. It is therefore
recommended that further similar but larger studies be
performed. A larger study should also bring out any
associations between certain karyotypes and morphologi cal
types of acute leukaemia.

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