Non-Hodgkin’s Lymphomas in Greece according to the WHO Classification of Lymphoid Neoplasms

Abstract

The purpose of this retrospective study, the largest unselected series in our country, was to illustrate the clinicopathological features of non-Hodgkin’s lymphoma (NHL) classified according to the World Health Organization (WHO) classification of lymphoid neoplasms. A retrospective analysis was conducted and clinical features of histological subtypes were established in 810 patients (age ≧15 years) with NHL who were treated at 8 major centers representative of Greece. There were 435 males and 375 females 95% of them aged >30 years. B symptoms were present in 34% of the patients, while 45.3% had stages I–II and 54.6% had stages III–IV. LDH was increased in 37% of the patients. B cell lymphomas formed 88% of the cases whereas T cell lymphomas formed 12% of the total. Indolent lymphomas accounted for 31.1%, aggressive ones for 66.7% and very aggressive ones for 2.4% of all NHLs. Among indolent lymphomas extranodal ones (MALT B cell lymphoma) were the most common subset while follicular lymphoma grade I and II and small lymphocytic ones presented with equal frequency. Among the aggressive lymphomas diffuse large cell lymphoma (DLCL) was the most common subtype; this entity along with large-cell immunoblastic lymphomas accounted for 45.2% of all B cell lymphomas. Among the T cell lymphomas, peripheral T cell lymphomas and anaplastic large cell lymphomas of the T/null-cell type were the most common subtypes. The most common extranodal presentation was the gastrointestinal tract (GI). Next in frequency were primary extranodal NHL of the head and neck region. MALT B cell lymphomas were found in almost half of the patients with GI tract NHL, whereas in all other extranodal places DLCL was the predominant histological subtype. The median survival for indolent and aggressive NHL was 123.5 and 55.5 months, respectively. This is the first report of a large series of malignant lymphomas in Greece using the WHO classification. It appears that there are no significant differences between NHL in Greece and other large series as far as clinical and extranodal presentation is concerned. The frequency of follicular lymphoma in the current study is comparable to that reported from Asian countries and mainland Europe, but lower than that of US and Northern European series. There were no important differences in the incidence of the remaining histological subtypes between Greece and other European countries.

Clinicopathologic and Survival Characteristics of Childhood and Adolescent Non Hodgkin's Lymphoma in Yazd, Iran

“…33 (84.61%) of our cases had B cell lineage, 4 (10.25%) had T cell lineage and 2 (5.12%) of the cases belonged to miscellaneous group. The current study and similar reports from some of the surrounding Middle East countries as well as the West show a low relative proportion of T-cell lymphomas (Naresh et al, 2004;Economopoulos et al, 2005). It was claimed that non Hodgkin lymphoma, occurring in adolescence was an independent risk factor for a poorer prognosis compared with that occurring in children younger than 15 years of age (Cairo et al, 2003).…”

Malignant lymphoma in northern Iraq: A retrospective analysis of 270 cases according to the World Health Organization classification

“…[3] The current study and similar reports from some of the surrounding Middle East countries as well as the West show a low relative proportion of T-cell lymphomas. [2,8,21,22,30,31,35] This is in contrast to its high proportion in Far Eastern countries like Japan, China, and Korea were it constitutes 27−30.5% of NHL, [4,5,36] and to a lesser extent the 15-18% reported from India. [27,28] Such significant variation in the geographical distribution of T-cell lymphomas has long been recognized and has been attributed to racial predisposition, HTLV-I viral infection and lower relative incidence of B-cell NHL in the Far East.…”

“…[1] Studies from Western Europe, North America, Japan, China, India, and some Middle Eastern countries have revealed that the relative proportions of various ML as determined by this classification differs with geographical region. [1][2][3][4][5][6][7][8] ML is the third most common reported malignancy in Iraq, [9] but there are few published Iraqi studies on the subject [10][11][12][13][14] and none have addressed the relative distribution of the various subtypes based upon the WHO classification. This study was undertaken in order to determine the types of ML occurring in the country as based upon the WHO updated classification [15,16] and to compare the distribution of diagnoses with published studies from nearby Middle Eastern countries as well as other developed and underdeveloped regions of the world.…”

Clinical and pathological evaluation of histopathological subtypes in patients with non-Hodgkin’s lymphoma

“…Male dominancy rates differed among countries (USA, 1.43; Europe. 1.23: Austria, 1.52; Greece 1.16, and Korea, 1.6 [8][9][10][11][12].…”