Research Articles

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A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community

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Now showing 1 - 9 of 9
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    Presenting clinical features of Burkitt's lymphoma in Ghana, West Africa.
    (Journal of Tropical Pediatrics and Environmental Child Health, 1979) Biggar, R.J.; Nkrumah, F.K.; Perkins, I.V.
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    Survival of burkitt's lymphoma patients in Ghana
    (British Journal of Cancer, 1971) Wosornu, J.L.; Nkrumah, F.K.; Perkins, I.V.
    Of 141 suspected cases of Burkitt's lymphoma referred from all over Ghana between November 1965 and June 30, 1969, the diagnosis of Burkitt's lymphoma was confirmed histologically in 60. This report deals with survival of all 50 treated and evaluable cases. The overall estimated long term survival rate was 38·5% calculated actuarially. It was 63·2% for Stage I (10 of 18); 20·0% for Stage II (2 of 10); and 25·4% for Stages III and IV combined (3 of 22), thus confirming the value of staging as a rough guide to prognosis. Six Stage I patients who died all had large tumors. These results have been compared with a similar study by Morrow et al. (1967) from Uganda.
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    Evaluation of CCNU (NSC 79037) used for the prevention of CNS involvement in burkitt's lymphoma
    (Cancer chemotherapy reports, 1975) Ziegler, J.L.; Magrath, I.T.; Nkrumah, F.K.; Perkins, I.V.; Simon, R
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    Combination chemotherapy in abdominal Burkitt's lymphoma.
    (Cancer, 1977) Nkrumah, F.K.; Perkins, I.V.; Biggar, R.J.
    In a clinical trial, 42 patients with abdominal Burkitt's lymphoma (BL) were treated with a combination regimen, code-named CVA, consisting of cyclophosphamide (CTX), vincristine, and cystosine arabinoside. In addition, intrathecal methotrexate (i.t. MTX) was administered as prophylaxis against subsequent central nervous system (CNS) involvement. Induced remissions, relapse, and survival were compared with those in a preceding group of 44 patients with abdominal BL treated with CTX along. Remission rate did not differ significantly in the two treatment groups, although induced remissions were higher in the CVA plus i.t. MTX-treated group (94% vs. 83%). Remission duration was significantly increases (p less than .05) and CNS relapse significantly reduced (p less than .05) in the group treated with CVA and i.t. MTX. The combination therapy was associated with higher early deaths during treatment, which adversely affected the overally survival. It is suggested that a reduction of the initial chemotherapeutic doses, particularly for patients with extensive tumor load, could further improve on the results of this trial.
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    Sickle cell trait, hemoglobin C trait, and Burkitt's lymphoma.
    (American Journal of Tropical Medicine and Hygiene, 1976) Nkrumah, F.K.; Perkins, I.V.
    In a controlled study in Ghana, the hemoglobin electrophoretic pattern in 112 patients with Burkitt's lymphoma was compared to that of their nearest neighbor controls of the same age, sex, and tribe, as well as their sibling controls. Analysis of the data obtained did not show any statistically significant protective advantage for sickle cell trait against Burkitt's lymphoma. Hemoglobin C trait appeared to offer a slight protective advantage (p<0.1), but this did not reach statistical significance. These results do not disprove the malaria co factor hypothesis in the etiology of Burkitt's lymphoma, but deprive it of an additional indirect evidence in its favor.
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    Relapse in Burkitt's lymphoma.
    (International Journal of Cancer, 1976) Nkrumah, F.K.; Perkins, I.V.
    Of 109 patients with histologically confirmed Burkitt's lymphoma who completed a course of chemotherapy, 86 (79%) achieved complete remission. Forty-five (52%) of patients with initial complete remission relapsed with tumour over an observation period ranging from 2 years to over 5 years. Relapse was more common in patients who initially presented with abdominal or central nervous system (CNS) involvement than in patients who presented with localized facial tumours (p<0.01). Anatomical distribution of tumour on relapse differed from that at presentation. Facial bones were much less frequently involved on relapse; on the other hand, the CNS, cranial nerves, orbits and skin were frequent sites of disease on relapse. CNS involvement occurred in 42% (19/45) of patients at the first relapse and in 73% (11/15) of patients with multiple relapses. Prognosis in these patients was poor. Two relapse types were clinically identifiable. Early relapse (remission duration<12 weeks) was associated with frequent involvement of the CNS, drug resistance and a generally unfavourable outcome. Patients with late relapse (remission duration >12 weeks) responded much better to secondary treatment. Possible pathogenic mechanisms underlying these two relapse types are discussed.
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    Neurological manifestations of Burkitt's lymphoma in Ghana.
    (African Journal of Medical Science, 1973) Nkrumah, F.K.; Perkins, I.V.
    Over a period of 2 1/4 years, 75 patients with histologically confirmed Burkitt's lymphoma were evaluated at the Korle Bu Teaching Hospital in Accra. 25 patients (33%) presented or developed evidence of central nervous system involvement. Neurological abnormalities included paraplegia, cranial neuropathy, peripheral and root neuropathy, headaches and altered consciousness. Malignant pleocytosis was present or subsequently developed in twenty four patients. Intrathecal methotrexate transiently reversed the malignant pleocytosis, without influencing the ultimate course of the disease appreciably in most of the patients. Survival among these 25 patients was poor compared to patients who did not develop CNS involvement.
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    Burkitt's lymphoma in Ghana: Clinical features and response to chemotherapy.
    (International Journal of Cancer, 1973) Nkrumah, F.K.; Perkins, I.V.
    The clinical presentation, response to chemotherapy, relapse pattern and prognosis in Burkitt's lymphoma were evaluated in a prospective manner in 54 patients. Cyclophosphamide induced complete clinical remission in over 75% of the patients irrespective of stage of the disease. Long-term sustained remissions, however, were mostly obtained in patients with localized disease (stage I-II). Patients with abdominal tumours (stage III), though showing good initial response to chemotherapy, had a high relapse rate, Intrathecal methotrexate transiently normalized cerebrospinal fluid cell counts in patients with malignant pleocytosis (stage IV). Early meningeal relapse was the rule and the patients did very poorly. Fifteen of the 54 patients have remained tumour-free and without recurrence for periods ranging from 1 to 2 years. Three patients who had tumour recurrences are also at present tumour-free after retreatment. Early tumour relapse was usually associated with a poor prognosis. The calculated long-term survival rate for all patients in the series was 33.1%.
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    Sequential evaluation of cutaneous delayed hypersensitivity responses to recall and to lymphoid cell line antigens in Burkitt's lymphoma.
    (International Journal of Cancer, 1977) Nkrumah, F.K.; Herberman, R.; Biggar, R.; Perkins, I.V.
    Delayed cutaneous hypersensitivity reactions to standard recall antigens (candidin, mumps and PPD), to crude membrane extracts of a cell line derived from Burkitt's lymphoma (Raji) and to a cell line derived from normal lymphocytes (F265) were sequentially evaluated in 44 patients with Burkitt's lymphoma. Sixteen patients (36%) manifested delayed hypersensitivity responses to the standard antigens and seven (16%) to the Raji membrane extract at presentation. Following successful chemotherapy, there was prompt and significant improvement of reactivity to both the standard and Raji antigens (p>0.001), suggesting that the initial impairment of delayed hypersensitivity was most likely related to tumor burden. By 9 months after treatment, all patients in sustained remission expressed reactivity to Raji and 21 of 22 to the standard antigens. None of the patients skin-tested with the F265 extract at presentation gave a positive response and only one subsequently expressed reactivity after remission was induced. On relapse, reactivity to the standard antigens was more readily lost (4 of 11) than reactivity to the Raji extract (1 of 7). Pretreatment delayed hypersensitivity to the standard antigens also correlated better with long-term survival than to pretreatment responses to Raji. It remains to be determined whether the antigens expressed in the Raji extract are indeed tumor-specific or related to Epstein-Barr virus.