PEDIATRIC HEMATOLOGY AND ONCOLOGY IN SOUTH-AFRICA

There are many influences on the disease patterns seen in South Africa which lies outside the African malarial belt but has received migrant s from the rest of Africa and from Europe over centuries, as well as b eing the seat of sociopolitical upheaval. Mortality rates reflect both First and Third World patterns. Red cell polymorphisms, common in oth er parts of Africa, are seen only in the migrant population. The found er effect is thought to account for a higher prevalence of diseases su ch as Fanconi's anemia and porphyria among Afrikaners. Only two-thirds of the expected number of malignancies are registered each year, with a pattern more akin to Western countries than to the rest of Africa. Differences are noted between black and white patients with respect to disease incidence, remission rates, and disease-free survival, the re asons for which are being sought. Malignant diseases are a low-priorit y pediatric problem in the developing world. In South Africa, faciliti es are available, including those for bone marrow transplantation, for state-of-the-art treatment, but socioeconomic problems do not always allow their full utilization by all sections of the population. This s hould change in a post-apartheid South Africa, and it will become easi er to determine whether observed differences are genetic or environmen tal.