Browsing by Author "Wamala Kalanzi, Edris"

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    Safety and feasibility of autologous adipose-derived stromal vascular fraction in the treatment of keloids: a phase one randomized controlled pilot trial
    (American Journal of Stem Cells, 2023) Mbiine, Ronald; Kayiira, Anthony; Wayengera, Misaki; Guyton, Munabi Ian; Kiwanuka, Noah; Alenyo, Rose; Wamala Kalanzi, Edris; Muwonge, Haruna; Nakanwagi, Cephas; Joloba, Moses; Galukande, Moses
    Autologous adipose-derived stromal vascular fraction (SVF) has been described to have therapeutic benefits in the treatment of keloids. However, most of the evidence on its efficacy is based on observational studies the majority of which are conducted in high-income countries and yet the highest burden of keloids is in low- and middle-income countries (LMICs). Objectives: We set out to determine the safety and feasibility of using autologous adipose derived stromal vascular fraction in the treatment of keloids in LMICs. Methods: In this phase II randomized controlled pilot clinical trial conducted in the Plastic Surgery Unit of Kirruddu National Referral Hospital in Kampala Uganda, 8 patients were assigned a 1:1 ratio to either SVF or triamcinolone acetonide (TAC) arms. In the SVF arm, a median (Inter quartile range) amount of stromal cell infiltration of 2.7×106 (11×106) was administered, while the controls received 10 mg/ml TAC at a ratio of 1:1 TAC to keloid volume. Primary endpoints were adverse event development based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 tool and feasibility assessment based on ≥ 70% recruitment feasibility and ≥ 80% interventional feasibility rates. Results: The participants’ mean age was 27.9 (±6.5) years, with a female predilection of 5 (63%). Overall, no adverse events were reported in the SVF arm, while ulceration in a single patient in the TAC arm, which was a grade II adverse event, was reported. Recruitment feasibility of 80% and interventional feasibility with 100% completion were reported. Conclusion: Based on our findings, an autologous adipose-derived stromal vascular fraction is feasible and safe for the treatment of keloids in LMICs.
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    A Supraclavicular ALK-Positive Anaplastic Large-Cell Lymphoma Initially Misdiagnosed and Yet Successfully Treated with Wide Excision and Adjuvant Chemotherapy: a Case Report
    (SN Comprehensive Clinical Medicine, 2019) Lekuya, Hervé Monka; Wamala Kalanzi, Edris; Mbiine, Ronald; Omoding, Abraham; Rosenwald, Andreas; Lemperle, Gottfried; Bringmann, Gerhard
    ALK-positive Anaplastic Large-Cell Lymphomas (ALCL) are chemo-sensitive cancers; combination of histologic and immunophenotypic or genetic studies remains the main strategy to prevent their unnecessary surgical excision as they canmimic softtissues sarcomas in histology. In sub-Saharan Africa, however, availability and affordability of immunophenotypic studies, especially extended immunohistochemistry (IHC) tests, constitute major limitations for accurate diagnoses. The case presented herein is an example of a heavy surgical management resulting from an initially inaccurate diagnosis, but eventually treated successfully. Case presentation A 15-year-old female patient presented with a 5-month history of a painless right supraclavicular mass. The initial biopsies had conflicting histology reports. In view of its rapid growth, it was first managed surgically, as a high-grade sarcoma stage T4N1M0: a wide “en bloc resection” with primary flap covering was done. Post-operative histology with an extended IHC from the widely resected tissue finally revealed an ALK-positive ALCL, which proved to be sensitive to chemotherapy. An adjuvant chemotherapy of six cycles of CHOP regimen followed with a good response; the patient became clinically stable, and all the investigations that were done, including a PET-CT scan, could not detect any residual active disease. She was still disease-free at 2 years after completion of chemotherapy. Conclusions Although cost-effective, combined histologic and immunophenotypic studies, especially extended IHC tests, can reduce the incidence of misdiagnosed large-cell lymphoma. As exemplified in this present case, obtaining appropriate and sufficient tissue from the tumor could possibly increase the chance of finding an accurate diagnosis.