Epidemiology and management of lymphoma in low‐income countries

Zucca, Emanuele; Rohatiner, A. Z. S.; Magrath, Ian; Cavalli, Franco

doi:10.1002/hon.945

Cited by 10 publications

(6 citation statements)

References 29 publications

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“…DLBCL accounts for 30–40% of all non-Hodgkin lymphomas in Western countries, and even reaches 40–60% in some Far East countries. 1–5 DLBCL is a heterogenous disease, consisting of different biological and clinical properties, as well as responses to treatment. 4 For these reasons, many predictive models have been proposed to stratify the prognosis of DLBCL.…”

Section: Introductionmentioning

confidence: 99%

MUM1 Expression versus Hans Algorithm to Predict Prognosis in Indonesian Diffuse Large B-Cell Lymphoma Patients Receiving R-CHOP

Irawan¹,

Iskandar²,

Harahap³

et al. 2022

CMAR

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Background Treatment response in diffuse large B-cell lymphoma (DLBCL) is heterogenous. The Hans algorithm (using 30% cut-offs for CD10, BCL6, and MUM1 protein expression) has been the most favored method to categorize DLBCL into germinal center B-cell (GCB) and non-GCB subtypes in order to predict prognosis. However, the algorithm’s ability to prognosticate is not always consistent. Methods This retrospective cohort study was conducted on DLBCL patients receiving R-CHOP therapy at Dr. Cipto Mangunkusumo Hospital, Jakarta from 2014 to 2017. We aimed to compare the prognostic value of Hans algorithm as well as the protein levels of CD10, BCL6, MUM1, and Ki67 at different cut-offs. Ninety-two patients were classified based on Hans algorithm and various proteins at different cut-off values were analyzed with regard to event-free survival at 24 months using survival analysis. The cut-off values were then compared using receiver operating characteristic curves. Results A significant survival difference was observed with MUM1 expression cut-off of 50% or more (log rank p = 0.035). CD10, BCL6, Ki67, and Hans algorithm showed AUCs below or near 0.5 (0.405, 0.436, 0.498, and 0.413, respectively), whereas MUM1 showed an AUC of 0.835, in predicting events within 24 months. MUM-1 cut-off of 70.5% yielded an optimal trade-off for sensitivity and specificity. Conclusion MUM1 expression of 50% or more can help predict prognosis in DLBCL patients receiving R-CHOP therapy and can be considered as for use as a single marker to predict prognosis.

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Section: Introductionmentioning

confidence: 99%

MUM1 Expression versus Hans Algorithm to Predict Prognosis in Indonesian Diffuse Large B-Cell Lymphoma Patients Receiving R-CHOP

Irawan¹,

Iskandar²,

Harahap³

et al. 2022

CMAR

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“…In contrast, in developing countries, their care faces the problems of unavailability and expensiveness of many treatments as much as the problem of late diagnosis (4,5). On the other hand, there is little data available on their treatment and their outcome due to the fact that medical databases are often incomplete or nonexistent, particularly in Africa (6,7). In Madagascar, until 2011, there was only one cancer center, thus, only a few studies on the therapeutic aspects and outcome of all hematological ma-lignancies was conducted.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Aspects and Outcome of Hematological Malignancies at the Military Hospital of Antananarivo, Madagascar

et al. 2019

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Background: Currently, the prognosis of hematological malignancies continues to improve in developed countries. In developing countries, such as Madagascar, data on hematological malignancies treatment and outcome are often rare, incomplete, or nonexistent. Until 2011, there was only one cancer center in Madagascar. The Medical Oncology Unit of the Military Hospital of Antananarivo, Madagascar, managed hematological malignancies since December 2012. This pathology represents there the fourth most frequent cancer. Objectives: We aimed to describe the therapeutic aspects and outcome of hematological malignancies managed at this center. Methods: This was a longitudinal study (descriptive and analytic) carried out from December 1, 2012 to August 31, 2015 (33 months). We included all patients followed, then, excluded those without pathologic evidence, cases of monoclonal gammopathy of unknown significance, and cases of solid cancers. Results:We followed up 57 cases of hematological malignancies. The mean age was 49.4 ± 15.5 years and sex ratio (male/female) was 1.71. A total of 34 patients (60%) received specific treatment and 40% of the patients undertook only symptomatic treatment.The median follow-up time was 60 days and mean survival time was estimated at 410 ± 61 days for all patients combined. The mean survival time varied significantly according to the nosological subgroup and to the type of treatment received (P = 0.004). At the end of the study 20 patients (35.1%) died and 17 patients (29.8%) were lost to follow-up. Conclusions: Our results are globally similar to the results found in other African studies. Improving diagnosis, establishing a hematopoietic stem cell transplant center, and improving access to specific therapies should improve the prognosis of our patients.

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“…HL most frequently involves lymph nodes; primary extranodal involvement is rare[2]. Extranodal organ involvement occurs more ofter in non-Hodgkin's lymphoma (NHL) than in HL, and distinct extranodal sites show different incidence of involvement[2]–[4].…”

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confidence: 99%

Clinical characteristics of the patients with Hodgkin's lymphoma involving extranodal sites

Li¹,

Zhu²,

Xia³

et al. 2012

Chin J Cancer

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Differences between Hodgkin's lymphoma (HL) patients in China and Western countries are known to exist, but data on Chinese patients with HL are limited. It is not clear whether there are clinical and histological differences in patients with HL involving different extranodal sites. This is the first study to analyze Chinese patients with HL involving different extranodal sites. We selected 22 HL patients with extranodal involvement from more than 250 previously untreated HL patients. Most patients were young males, and 20 of the 22 patients had stage IV disease. The major pathologic types were nodular sclerosis classical HL (NSCHL) and mixed cellularity classical HL (MCCHL). At diagnosis, the most commonly involved extranodal sites were the liver and lung, followed by the bones. There was no significant association between the international prognostic score (IPS) and survival in patients with different extranodal sites. Our data showed the overall survival (OS) and disease-free survival (DFS) rates of low-risk group (IPS = 0-2) were relatively higher than those of high-risk group (IPS ≥ 3), but the IPS did not show predictive power for survival. Although HL with extranodal involvement is rare, it should be considered as a unique form of HL.

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Epidemiology and management of lymphoma in low‐income countries

Cited by 10 publications

References 29 publications

MUM1 Expression versus Hans Algorithm to Predict Prognosis in Indonesian Diffuse Large B-Cell Lymphoma Patients Receiving R-CHOP

MUM1 Expression versus Hans Algorithm to Predict Prognosis in Indonesian Diffuse Large B-Cell Lymphoma Patients Receiving R-CHOP

Therapeutic Aspects and Outcome of Hematological Malignancies at the Military Hospital of Antananarivo, Madagascar

Clinical characteristics of the patients with Hodgkin's lymphoma involving extranodal sites

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