Non-Hodgkin's lymphoma in Pakistan: a clinicopathological profile of 175 patients.
OBJECTIVE
Non-Hodgkin's Lymphomas (NHL) are common in Southeast Asia, Middle East and Africa. The study was primarily undertaken to establish the demographic and clinicopathologic features of NHL in Pakistan. A secondary aim was to determine the applicability of the International Prognostic Index (IPI) developed by the international lymphoma task force in a developing country.


METHODS
A retrospective and prospective analysis was performed on 175 patients over 14 years age who presented to the Department of Oncology between August 1994 and December 1996. All patients underwent initial staging according to Ann Arbor Staging System. Histopathologic classification was done according to the International Working Formulation. The IPI was applied to patients with aggressive lymphomas and age adjusted index to patients < 60 years, complete remission (CR), disease free survival (DFS) and overall survival (OS) were calculated.


RESULTS
All 175 patients were evaluable. Median age of our patients was 45 years. Male to female ratio was 1.9:1. Seventeen (9.7%) patients were classified as low grade lymphomas while 158 (91.3%) had intermediate and high grade NHL. Large cell lymphoma was present in 30.9% patients. CHOP (cyclophosphamide 650 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, doxorubicin--45 mg/m2 day 1 and prednisone 100 mg/m2 day 1-5) was the most common chemotherapy regimen used. Advanced stage (74.9%) > B symptoms (51%) and extranodal involvement (74.3%) were present. One hundred sixty-seven patients were evaluable for response of which 42.8% achieved CR. Median DFS was 19 months and median OS was 22 months. The IPI was applicable to 153 patients and age adjusted IPI to 124 of 153 patients.


CONCLUSIONS
Aggressive histology, extranodal diseases, B symptoms and advanced disease are common. International index and age adjusted international index predicted outcome accurately in various risk groups.
Aziz
Z
Z
Department of Medical Oncology, Allama Iqbal Medical College, Lahore.
Rehman
A
A
Akram
M
M
Saeed
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate