Response to Rituximab in Non-Hodgkin Lymphoma Patients at National Oncology Center, Aden, Yemen, 2017-2020:  Retrospective Cohort Study

Abstract

Background: Rituximab is currently approved for the treatment of relapsed and refractory indolent lymphomas, which was added to the protocol in Yemen although it was highly costly. The study aimed to determine the long-term response of rituximab on Non-Hodgkin Lymphomas (NHL) patients. Methods: A retrospective cohort study was conducted in the National Oncology Center (NOC) in Aden by review of medical registries for NHL patients from 2017-2020. Sociodemographic and clinical data were extracted from patients’ files by a well-trained team. SPSS version 23 was used for the analysis of data, and Kaplan Meier survival curve was used to measure overall survival (OS) and progression-free survival (PFS) between two groups CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) and rituximab-CHOP group in two follow up periods (12-months and 4-years). Cox regression was used to evaluate the association between the risk factors. A P-value of < 0.05 at a confidence interval of 95% is considered statistically significant. Results: Of 100 patients, 50 for each group of CHOP and R-CHOP. The under 60 years represented 70%. Advanced Stage represented 64% and diffuse large B cell lymphoma represented 47% of all subtypes of NHL. Significant association difference in OS in two periods of follow-up (12-month and 4-years) for CHOP vs. R-CHOP was 63% vs. 86%, and 10% vs. 33%, respectively (P=0.01 and P=0.04). In contrast, the difference was non-statically significant in the PFS in two periods 39% vs. 66%, and 12% vs. 27% for CHOP vs. R-CHOP, respectively (P=0.10 and P=0.31). The age group > 60 years, ≥ 6 cycles of chemotherapy received, abnormality of LDH, and married patients were the significantly hazard proportion that was associated with poor prognostic factors (P= 0.009, 0.001,0.010, and 0.011, respectively). Conclusion: The addition of rituximab to CHOP chemotherapy had a statistical difference in overall survival and there is no difference in PFS. Elderly, married patients, more than 6 cycles of chemotherapy received, and abnormality of LDH were the most important prognostic factors. Therefore, providing the oncology center with Rituximab for ongoing use of NHL patients especially those under 60 years, further assessment for hospital-related risk factors that lead to decreased survival are recommended.

Evaluation of Antiemetic Consistency in Chemotherapy-Induced Nausea and Vomiting Among NHL Patients in Sana’a, Yemen

“…16 NHL dominates among patients with lymphoma, accounting for 65% of all cases. 17 Despite this alarming prevalence, there is a notable lack of research focusing on CINV experiences of patients with Yemeni NHL. This study aimed to fill this research gap, evaluate the consistency of antiemetic medication practices with the NCCN guidelines, and explore the influencing factors among patients with NHL at the National Oncology Center (NOC), the largest oncology center in Yemen.…”

Evaluation of clinicians’ knowledge and practice regarding pharmacotherapy of Non-Hodgkin’s lymphoma: A multi-center study in Yemen

“…The 5-year prevalence of NHL cases was 1,829, representing 5.8% of all prevalent cancer cases [ 17 ]. Particularly, in Aden Governorate, in Aden Governorate, NHL emerged as the predominant type of malignant hematological tumors in both 2010 and 2013, according to data from the National Oncology Center (NOC) [ 18 , 19 ]. Lymphomas comprised 9.8% of all cancer cases, with NHL representing 65% of all lymphoma patients [ 19 ].…”