title: Immunohistochemical and other prognostic factors in B cell non Hodgkin lymphoma patients, Kampala, Uganda.
abstract: BACKGROUND
  Non Hodgkin lymphomas are the most common lymphomas in Uganda. Recent studies from developed countries have shown differences in survival for the different immunophenotypes. Such studies are lacking in Africa where diagnosis is largely dependent on morphology alone. We report immunohistochemical and other prognostic factors in B cell non Hodgkin lymphoma patients in Kampala, Uganda.
  
  
  METHODS
  Non Hodgkin lymphoma tissue blocks from the archives of the Department of Pathology, Makerere University College of Health Sciences, Kampala, Uganda, from 1991-2000, were sub typed using haematoxylin and eosin, Giemsa as well as immunohistochemistry. Using tissue micro array, 119 biopsies were subjected to: CD3, CD5, CD10, CD20, CD23, CD30, CD38, CD79a, CD138, Bcl-6, Bcl-2, IRTA-1, MUM1/IRF4, Bcl-1/cyclin D1, TdT, ALKc, and Ki-67/Mib1. Case notes were retrieved for: disease stage, chemotherapy courses received and retrospective follow up was done for survival.
  
  
  RESULTS
  Non Hodgkin B cell lymphomas comprised of Burkitt lymphoma [BL] (95/119) diffuse large B cell lymphoma (19/119), mantle cell lymphoma (4/119) and precursor B lymphoblastic lymphoma (1/119). For Burkitt lymphoma, good prognosis was associated with receiving chemotherapy, female gender and CD30 positivity. Only receiving chemotherapy remained significant after Cox regression analysis. Diffuse large B cell lymphomas with activated germinal centre B cell (GCB) pattern (CD10+/-, BCL-6+/-, MUM+/-, CD138+/-) had better survival (98.4 months; 95% CI 89.5 -107.3) than the others (57.3 months; 95% CI 35.5 - 79.0) p = 0.027 (log rank test).
  
  
  CONCLUSIONS
  Activated GCB diffuse large B cell lymphoma had a better prognosis than the others. For Burkitt lymphoma, not receiving chemotherapy carried a poor prognosis. Availability of chemotherapy in this resource limited setting is critical for survival of lymphoma patients.
authors.affiliation: Department of Pathology, Makerere University, College of Health Sciences, PO Box 7072, Kampala, Uganda.
authors.forename: Lynnette K
authors.initials: LK
authors.lastname: Tumwine
authors.forename: Claudio
authors.initials: C
authors.lastname: Agostinelli
authors.forename: Cristina
authors.initials: C
authors.lastname: Campidelli
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Othieno
authors.forename: Henry
authors.initials: H
authors.lastname: Wabinga
authors.forename: Simona
authors.initials: S
authors.lastname: Righi
authors.forename: Brunangelo
authors.initials: B
authors.lastname: Falini
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Piccaluga
authors.forename: Wilson
authors.initials: W
authors.lastname: Byarugaba
authors.forename: Stefano A
authors.initials: SA
authors.lastname: Pileri