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Rahiman EA, Bakhshi S, Deepam Pushpam, Ramamoorthy J, Das A, Ghara N, Kalra M, Kapoor G, Meena JP, Siddaigarhi S, Thulkar S, Sharma MC, Srinivasan R, Trehan A. Outcome and prognostic factors in childhood B non-Hodgkin lymphoma from India: Report by the Indian Pediatric Oncology Group (InPOG-NHL-16-01 study). Pediatr Hematol Oncol 2022; 39:391-405. [PMID: 34978257 DOI: 10.1080/08880018.2021.2002485] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The literature on B-non-Hodgkin lymphoma (NHL) in India is restricted to individual hospital data. The study aimed to evaluate the epidemiology and outcome of B-NHL in our country. One hundred and ninety-one patients of B-NHL from 10 centers diagnosed between 2013 and 2016 were analyzed retrospectively. B/T lymphoblastic lymphoma and patients with inadequate data were excluded. The median age was 88 months (IQR: 56, 144) with an M:F ratio of 5.6:1. Undernourishment and stunting were seen in 36.5% and 22%. Primary site was abdomen in 66.5%. Hypoalbuminemia was noted in 82/170 (48.2%). Histological subtypes: Burkitt lymphoma (BL): 69.6%, Burkitt-like: 10.4%, and diffuse large B cell lymphoma (DLBCL): 13.6%, unclassified and others (6.4%). Stage distribution: I/II, 33 (17.3%), III, 114 (59.7%), and IV, 44 (23%). One-eighty-six patients took treatment. Protocols used were LMB and BFM in 160/186 (86%). At a median follow-up of 21.34 (IQR: 4.34, 36.57) months, the disease-free-survival (DFS) was 74.4% and event-free-survival (EFS) was 60.7%. Treatment-related mortality (TRM), relapse/progression and abandonment were 14.3%, 14.5%, and 8.4%, respectively. Bone marrow positivity, stage IV disease, and lactate dehydrogenase (LDH) > 2,000 U/l predicted inferior EFS. Stage IV disease, LDH > 2,000 U/l, bone marrow positivity, tumor lysis syndrome and low albumin predicted TRM; LDH retained significance on multivariate analysis for EFS and TRM [OR: 4.54, 95% CI: 1.14-20, p 0.03; OR 20, 95%CI: 1.69-250, p 0.017]. BL was the main histological subtype. High TRM and relapse/progression are hampering survival. An LDH > 2,000 U/l was adversely prognostic. These data demonstrate a need to develop a national protocol that balances toxicity and potential for cure.
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Affiliation(s)
- Emine A Rahiman
- Pediatric Hematology-Oncology Unit and Cytology Department, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sameer Bakhshi
- Rotary Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
| | - Deepam Pushpam
- Rotary Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Jagdish Prasad Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sanjay Thulkar
- Rotary Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
| | - Meher Chand Sharma
- Rotary Cancer Institute, All India Institute of Medical Sciences, New Delhi, India
| | - Radhika Srinivasan
- Pediatric Hematology-Oncology Unit and Cytology Department, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amita Trehan
- Pediatric Hematology-Oncology Unit and Cytology Department, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Meena JP, Gupta AK, Parihar M, Seth R. Clinical profile and outcomes of Non-Hodgkin's lymphoma in children: A report from a tertiary care hospital from India. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_70_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Non-Hodgkin's lymphoma (NHL) is an aggressive malignancy. Its outcome has improved over the past decades. Although it accounts for 8%–10% of all childhood cancers, very less information about its clinical presentation and outcomes is available from India. Our objective was to study the clinical presentation and outcomes in children (<15 years) with NHL at our center. Methodology: We retrospectively analyzed 26 children diagnosed with NHL at our center from August 2008 to June 2014 and followed them up to May 2017. Results: The median age at the time of diagnosis was 7.7 years (2.5–13 years). Abdominal distension and an abdominal lump were the most common presenting features occurring in 75%, followed by fever (73.8%) and weight loss (46.2%). Most patients had advanced-stage (Stage III/IV, 92.3%) disease at presentation. The primary presentation was extranodal in 57.7%, nodal in 26.9%, and combined in 15.4%. Burkitt's lymphoma (BL) was the most common subtype (46.2%), followed by T-lymphoblastic lymphoma, diffuse large B-cell lymphoma, and anaplastic large-cell lymphoma. Three patients did not take treatment. The median follow-up of patients was 48 months (36–99 months). Nineteen patients achieved remission and four had progressive disease. Significantly better event-free survival (EFS) was found with younger age and lower stage of presentation. The EFS did not significantly differ with sex, group of disease, lactate dehydrogenase levels, and presenting features. Conclusions: Our cohort of patients with NHL showed characteristics similar to those reported from other developing countries. NHL occurred at a younger age, with a higher incidence of BL. The outcome for patients aged >10 years was poor. The outcome of NHL was comparable to that of other centers in the world.
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Affiliation(s)
- Jagdish Prasad Meena
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Kumar Gupta
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Mansingh Parihar
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
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Gunge RA, Kalgutakar AD. Profile of Childhood Non-Hodgkin Lymphomas at a Tertiary Care Hospital. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_230_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractContext: Lymphoma was the second most common malignancy accounted for 22% of pediatric cases, of which 34 (68%) were non-Hodgkin’s lymphoma (NHL). Aims: To find the incidence, clinical presentations, laboratory findings, proportion of extranodal involvement, and to study histological subtypes (REAL/WHO classification) of NHL, compare them with reported case series in the world literature. Settings and Design: Gross specimens and biopsies of pediatric NHL were retrieved from the Department of Surgical Pathology from the year 2004 to 2013 at a tertiary care hospital. Patients and Methods: Gross and microscopy of incisional biopsies and surgically resected specimens of pediatric cases were studied using hematoxylin and eosin stain and wherever needed special stain and immunohistochemistry were used. Results: The incidence of NHL was higher in more than 10 years of age group with male predominance. Burkitt’s lymphoma (BL) (41.2%) was the most common subtype followed by T-lymphoblastic lymphoma (T-LL) (29.4%). Predominantly extranodal presentation was seen, BL presented as ileocecal masses (five cases) and orbital swelling (three cases). T-LL presented as a mediastinal masses (six cases). Rare cases of precursor B-LL involving orbital mass and plasmablastic lymphoma involving paranasal sinuses were studied. Among bone marrows studied a case of T-LL developed pancytopenia, during chemotherapy showed giant pronormoblast (Parvovirus infection). HIV association was seen in five cases of NHL. Postchemotherapy disease-free survival was very low and many patients died during chemotherapy. Conclusion: Although the incidence of HL is higher in children, in the present study, NHL with extranodal presentation (58%) involving rare sites with poor prognosis is higher, 15% of all cases showed HIV seropositivity.
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Affiliation(s)
- Ratnaprabha Anil Gunge
- Department of Pathology, Lokamanya Tilak Muncipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Alka D Kalgutakar
- Department of Pathology, Lokamanya Tilak Muncipal Medical College and General Hospital, Mumbai, Maharashtra, India
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Demographic Challenges of Pediatric NHL: A Report on 280 Patients. Indian J Pediatr 2018; 85:697-698. [PMID: 29238937 DOI: 10.1007/s12098-017-2563-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 11/24/2017] [Indexed: 11/26/2022]
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Doval DC, Bhurani D, Nair R, Gujral S, Malhotra P, Ramanan G, Mohan R, Biswas G, Dattatreya S, Agarwal S, Pendharkar D, Julka PK, Advani SH, Dhaliwal RS, Tayal J, Sinha R, Kaur T, Rath GK. Indian Council of Medical Research Consensus Document for the Management of Non-Hodgkin's Lymphoma (High Grade). Indian J Med Paediatr Oncol 2017; 38:51-58. [PMID: 28469337 PMCID: PMC5398107 DOI: 10.4103/0971-5851.203500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This consensus document is based on the guidelines related to the management of Non Hodgkin's Lymphoma (High grade) in the Indian population as proposed by the core expert committee. Accurate diagnosis in hematolymphoid neoplasm requires a combination of detailed history,clinical examination, and various investigations including routine laboratory tests, good quality histology section (of tumor and also bone marrow aspirate/biopsy), immunostaining, cytogenetic and molecular studies and radiology investigations. The staging system used for adult high grade lymphomas is based on the Ann Arbor system and includes various parameters like clinical, haematology, biochemistry, serology and radiology. Response should be evaluated with radiological evaluation after 3-4 cycles and at the end of treatment based on criteria including and excluding PET. Treatment of high grade lymphomas is based on histologic subtype, extent of disease, and age of the patient. Autologous stem cell transplantation after high dose chemotherapy is effective in the treatment of relapsed NHL. Newer RT techniques like 3 dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) can significantly reduce radiation doses to surrounding normal tissues in lymphoma patients. Patients should be followed up every 3 to 4 months for the first 2 years, followed by 6 monthly for the next 3 years and then annually.
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Affiliation(s)
- Dinesh Chandra Doval
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Dinesh Bhurani
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Reena Nair
- Department of Hemato oncology, Tata Memorial Centre, Kolkata, West Bengal, India
| | - Sumeet Gujral
- Department of Hemato Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Pankaj Malhotra
- Department of Clinical Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ganpati Ramanan
- Department of Medical Oncology, Apollo MultiSpecialty Hospital, Chennai, Tamil Nadu, India
| | - Ravi Mohan
- Department of Internal Medicine and Medical Oncology, Guntur Medical College, Guntur, Andhra Pradesh, India
| | - Ghanshyam Biswas
- Department of Medical Oncology, Sparsh Hospitals and Critical Care, Bhubaneswar, Odisha, India
| | - Satya Dattatreya
- Department of Medical Oncology, Omega Hospital, Hyderabad, Telangana, India
| | - Shyam Agarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Dinesh Pendharkar
- Division of Non Communicable Disease, Indian Council of Medical Research, New Delhi, India
| | - Pramod Kumar Julka
- Department of Radiotherapy, Dr. BR Ambedkar Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Suresh H Advani
- Department of Medical Oncology, SL Raheja Hospital, Mumbai, Maharashtra, India
| | | | - Juhi Tayal
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Rupal Sinha
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Tanvir Kaur
- Division of Non Communicable Disease, Indian Council of Medical Research, New Delhi, India
| | - Goura K Rath
- Department of Radiotherapy, Dr. BR Ambedkar Institute of Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Sherief LM, Elsafy UR, Abdelkhalek ER, Kamal NM, Youssef DM, Elbehedy R. Disease patterns of pediatric non-Hodgkin lymphoma: A study from a developing area in Egypt. Mol Clin Oncol 2014; 3:139-144. [PMID: 25469284 DOI: 10.3892/mco.2014.425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/05/2014] [Indexed: 11/05/2022] Open
Abstract
Non-Hodgkin lymphoma (NHL) accounts for 8-10% of all childhood cancers. NHL collectively represents various lymphoid malignancies with diverse clinicopathological and biological characteristics. In this study, we aimed to describe the epidemiological and clinicopathological characteristics and treatment outcomes of pediatric NHL patients treated at the Pediatric Oncology Unit of Zagazig University Hospital and the Benha Specialized Pediatric Hospital. We conducted a cross-sectional retrospective study by reviewing the medical records of 142 patients admitted with a diagnosis of NHL over a period of 8 years (February, 2004 to February, 2012) in these two Oncology Units. The age at presentation ranged between 2 and 15 years, with a mean ± standard deviation (SD) of 6.1±2.8 years and a male:female ratio of 1.7:1. Abdominal involvement was the most common presentation (73.2%). Burkitt's lymphoma (BL) was the most common NHL subtype (69%), followed by lymphoblastic lymphoma, diffuse large B-cell lymphoma and anaplastic large-cell lymphoma, accounting for 18.3, 10.6 and 2.1% of the cases, respectively. The majority of the patients (88.7%) had been diagnosed with advanced disease (Murphy stage III/IV). Complete remission was achieved in 120 cases (84.5%). A total of 16 patients (11.3%) succumbed to the disease during the first few months and 6 patients (4.2%) remained alive following relapse. The mean follow-up duration ± SD was 34.6±25.1 months (range, 3-84 months). The 5-year overall survival (OS) and event-free survival (EFS) rates were 88.7 and 85.1%, respectively. None of the clinical, epidemiological or pathological variables exhibited a statistically significant association with the OS or EFS. In conclusion, NHL occurs at a younger age, with a higher incidence of BL and advanced-stage disease. The outcome of NHL in our two centers was satisfactory, approaching the international rates.
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Affiliation(s)
- Laila M Sherief
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt ; Benha Specialized Pediatric Hospital, Benha, Qalyubia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Usama R Elsafy
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Elhamy R Abdelkhalek
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt ; Benha Specialized Pediatric Hospital, Benha, Qalyubia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naglaa M Kamal
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa M Youssef
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rabab Elbehedy
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt
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Abstract
Pediatric non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of malignancies with distinct clinical, pathological, immunological and genetic characteristics. More than 90% of pediatric NHLs belong to one of three major histological subtypes: mature B-cell neoplasms, lymphoblastic lymphomas and anaplastic large-cell lymphomas. The recognition that different subtypes require different treatment regimens resulted in therapeutic strategies leading to over 80% of patients being cured. On the other hand, patients with resistant or relapsed disease have a poor prognosis. Prognostic biomarkers have not yet been identified for all pediatric NHLs and, although some are very important for diagnosis and prognosis, others may be of questionable value. Discovery of new biomarkers suitable for clinical application may aid the diagnosis and classification of lymphomas, which should, in turn, lead to better patient stratification. Consequent development of new treatment and follow-up approaches should lead to more efficient and less toxic treatment in children with NHL.
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Affiliation(s)
- Lidija Dokmanovic
- University Children's Hospital, Department of Hematology & Oncology, Faculty of Medicine, University of Belgrade, Dr Subotica 13, 11000 Belgrade, Serbia.
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Manipadam MT, Nair S, Viswabandya A, Mathew L, Srivastava A, Chandy M. Non-Hodgkin lymphoma in childhood and adolescence: frequency and distribution of immunomorphological types from a tertiary care center in South India. World J Pediatr 2011; 7:318-25. [PMID: 21633853 DOI: 10.1007/s12519-011-0303-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 11/15/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is a dearth of published literature on the frequency and distribution of pediatric and adolescent non-Hodgkin lymphoma (NHL) in India according to the 2001 WHO classification. The aim of this study was to record the distribution of the different subtypes, analyze the major subtypes, and compare it with the published data from other countries. A review of pediatric NHL statistics from population-based cancer registries was included in this study. METHODS The study was conducted using information retrieved from the files of our institution. A total of 467 patients with lymphoma (excluding mycosis fungoides) were recorded in the under 20 years group over a period of 6 years, of which 252 patients suffered from NHL. The demographic characteristics, frequency and distribution of different subtypes were noted and compared with published reports from other parts of the world. RESULTS T-lymphoblastic lymphoma/leukemia constituted the majority (32.1%) of all NHLs in children and adolescents in our study. The other major subgroups were Burkitt's lymphoma, anaplastic large cell lymphoma, and diffuse large B cell lymphoma. Burkitt's lymphoma in this study had clinical presentations similar to those seen in western countries. CONCLUSIONS The distribution of different subtypes of lymphoma in pediatric and adolescent NHL in India differs considerably from that in western countries and other eastern countries.
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Naresh KN, Advani S, Adde M, Aziz Z, Banavali S, Bhatia K, Belgaumi A, Ezzat A, Khaled H, Mokhtar N, Norton A, Rohatiner A, Sagar TG, Taciyliz N, Temmim L, Venkatesh C, Yan Tang J, Magrath I. Report of an International Network of Cancer Treatment and Research workshop on non-Hodgkin's lymphoma in developing countries. Blood Cells Mol Dis 2005; 33:330-7. [PMID: 15528153 DOI: 10.1016/j.bcmd.2004.08.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2004] [Indexed: 10/26/2022]
Abstract
The International Network of Cancer Treatment and Research (INCTR) recently organized a workshop on non-Hodgkin lymphomas (NHLs) in selected developing countries with the purpose of examining existing information relating to the pathology and management of these neoplasms, and identifying potential areas for research. This report provides a summary of the information presented and is focused primarily on the pathology of NHLs in children and adults. In most countries, the WHO classification of lymphomas was used and most participating centers included immunohistochemistry using a wide array of lymphoid antibodies as part of routine diagnosis. Some of the series had been reviewed by an external panel of experts. B-cell lymphomas accounted for 82-88% of all NHLs. The proportions of chronic lymphatic leukemia (4-6%), mantle cell lymphoma (MCL, 3-5%), and plasmacytoma (2-4%) were similar in the series presented. However, there was a significant variation in the proportion of follicular lymphoma (FL), which accounted for 15% and 11% in India and Kuwait, but less than 5% in Pakistan and Egypt. All of these frequencies are significantly lower than those reported in Western series. Diffuse large B-cell lymphoma accounted for about 35% of cases in India but for more 50% in other countries, but this difference was not accounted for by an increased incidence in a single lymphoma subtype in India, but rather an apparent paucity of several subtypes (such as mantle cell and marginal zone lymphomas (MZL)) in other series. There were relatively high frequencies of Burkitt lymphoma in Egypt (7%) and precursor T-cell lymphoblastic lymphoma in India (6-7%). Peripheral T-cell lymphomas (PTCLs) (not otherwise specified and angioimmunoblastic subtypes) accounted for 3-5% of NHLs, and extranodal lymphoma of T/NK cell type was rare (<1%). These differences in the relative proportions of NHL subtypes among developing countries and between developing countries and the rest of the world presumably arise from differences in environmental and genetic factors that influence lymphomagenesis and strongly suggest that more research in developing countries would provide valuable insights into the pathogenesis of lymphoid neoplasms.
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Affiliation(s)
- K N Naresh
- INCTR at Institut Pasteur, B-1180 Brussels, Belgium
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Naresh KN, Agarwal B, Nathwani BN, Diebold J, McLennan KA, Muller-Hermelink KH, Armitage JO, Weisenburger DD. Use of the World Health Organization (WHO) classification of non-Hodgkin's lymphoma in Mumbai, India: a review of 200 consecutive cases by a panel of five expert hematopathologists. Leuk Lymphoma 2004; 45:1569-77. [PMID: 15370208 DOI: 10.1080/10428190410001683679] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aims to answer the question whether the World Health Organization (WHO) classification of non-Hodgkin's lymphoma (NHL) can be practised to international standards at the Lymphoma Registry (LR) established at the Tata Memorial Hospital, Mumbai, India. Furthermore, the study aims to identify differences in the distribution of NHL subtypes at this LR (likely to be representative of India) as compared to the rest of the world. A panel of 5 expert hematopathologists from the NHL Classification Project reviewed 200 consecutive NHL cases at the LR in January of 2001. These cases were accrued during August and September, 2000. On all cases, hematoxylin and eosin stains and appropriate immunostains were available for review. The diagnosis made by the host pathologist at the LR (KNN) and the initial diagnosis made by each of the expert hematopathologists was compared with the consensus diagnosis. A consensus diagnosis was made by the 5 experts in 197 cases. The agreement of the host pathologist with the consensus diagnosis was 82% and the agreement of the individual experts with the consensus diagnosis varied from 76-88% (mean 82%). According to the consensus diagnosis, 80% of NHLs were of B-cell type, 18% were of T-cell type, and the immunophenotype could not be determined in the remaining 2% of cases. In conclusion, the WHO classification of NHL was properly utilized at the Lymphoma Registry, Mumbai, India, and geographic differences were noted in the distribution of NHL subtypes at the LR as compared to the rest of the world. Precursor T lymphoblastic leukemia/lymphoma was more common in India (7%) than the rest of the world (1-4%), and indolent B-cell NHLs (29%) were less common than in the West. As compared to China and Japan, peripheral T-cell lymphoma (4.6%), extranodal NK/T cell lymphoma, nasal type (0.5%) and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) (2.6%) were less common, but follicular lymphoma (15%) and chronic lymphocytic leukemia/small lymphocytic lymphoma (5%) were more common. This suggests that the distribution of the B-cell and T-cell lymphomas in the Indian population, except for lymphoblastic lymphoma, lies in between the Western world (mainly Caucasian) and the Orientals.
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Affiliation(s)
- Kikkeri N Naresh
- Lymphoma Registry, Department of Pathology, Tata Memorial Hospital, Mumbai, India.
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