1
|
Mbai MM, Mduma E, Thuo S, Rugengamanzi E, Malichewe CV, Lugina EL. A comparison of clinical profile and treatment outcome of Hodgkin's Lymphoma in Tanzania according to HIV status during the HAART era. BMC Cancer 2024; 24:796. [PMID: 38961368 PMCID: PMC11220972 DOI: 10.1186/s12885-024-12569-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The incidence of Hodgkin's lymphoma (HL) in people living with HIV (PLWHA) and on HAART is approximately 20-30 times higher than in HIV-negative individuals. Most patients with HIV-HL present at an advanced stage (III-IV) have 'B' symptoms and extranodal involvement. The natural history and risk stratification of HIV-HL has undergone a significant change as a result of HAART's rollout. This study investigated the differences in clinicopathological and survival patterns of HL among individuals with and without HIV disease in Tanzania during the HAART era. METHODOLOGY This hospital-based retrospective cohort study was conducted at the ORCI, Dar-Es-Salaam, Tanzania. Chi-square and Fisher's exact tests were used to compare proportions. The student t-test was used to compare means. To determine factors that predict survival, we used the log-rank test to analyze the variables in univariate analysis. A Cox regression model was used to analyze the significant factors from univariate analysis in multivariate analysis. RESULTS Eighty-three patients with HL were recruited, and the prevalence of HIV-positive status was 27.7%. Most of the patients with HIV-HL had an age of > 30 years (73.9%), while most of the non-HIV-HL patients had an age of ≤ 30 years (63.3%) (P = 0.02). The 2-year OS rate for HIV-HL was 34%, while that for non-HIV-HL was 67%. Among the HIV-HL patients, predictors of a poorer outcome were a CD4 count ≤ 200 cells/mm3 (P = 0.05), lack of HAART use (P = 0.00), and the use of HAART for ≤ 10 months (P = 0.00). CONCLUSION The prevalence of HIV-HL was 27.7% among HL patients. HIV positivity is still a poor prognostic factor in our setting, especially for patients not on HAART, on HAART for ≤ 10 months, or with a low CD4 count below 200 cells/mm3. Patients with HIV-HL were older and had higher LDH levels, whereas patients with non-HIV-HL were younger and had low LDH levels.
Collapse
Affiliation(s)
- Mercy M Mbai
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
- Department of Oncology, Longisa County Referral Hospital, Bomet, Kenya.
| | - Emmanuel Mduma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Department of Clinical Oncology, Rabininsia Memorial Hospital, Dar Es Salaam, Tanzania
| | - Samuel Thuo
- Department of Otolaryngology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Eulade Rugengamanzi
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Butaro Cancer Center of Excellence, Burera, Rwanda
- School of Medicine, University of Global Health Equity, Kigali, Rwanda
| | - Christina V Malichewe
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Emmanuel L Lugina
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Academic, Research and Consultancy Unit, Ocean Road Cancer Institute, Dar Es Salaam, Tanzania
| |
Collapse
|
2
|
Mremi A, Yahaya JJ, Abraham ZS, Mwakigonja AR. The Role of a Minimum Immunohistochemical Antibody Panel in Confirming Undifferentiated Nasopharyngeal Carcinoma: A Cross-Sectional Study at the Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Niger Med J 2020; 60:279-284. [PMID: 32180656 PMCID: PMC7053275 DOI: 10.4103/nmj.nmj_134_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/22/2019] [Accepted: 11/21/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction Nasopharyngeal carcinoma (NPC) is a malignant epithelial neoplasm arising in the nasopharyngeal mucosa that shows light microscopic and/or ultrastructural evidence of squamous differentiation. Immunohistochemistry (IHC) can be used to reliably distinguish undifferentiated NPC from other malignant tumors, and the technique may be a necessary tool toward the arrival of a definitive diagnosis, particularly when dealing with challenging cases. Materials and Methods This was a cross-sectional hospital-based study which was conducted at Muhimbili National Hospital. The study involved 120 patients with NPC who were diagnosed on histopathological basis between 2009 and 2013. Results The sensitivity and specificity of hematoxylin and eosin (H and E) stain in diagnosing NPC were 99% and 30.4%, respectively. The accuracy of H and E stain to diagnose NPC and lymphoma was 94.2% and 30.4%, respectively. CD45 antibody helped to confirm 16 cases which were diagnosed as NPC on H and E stain to be lymphoma. Further, AE1/AE3 antibody helped to confirm one case who was diagnosed as rhabdomyosarcoma on H and E stain to be NPC. Conclusions The sensitivity and accuracy of H and E stains to diagnose NPC were very high whereas the specificity was very low. A significant proportion of previously diagnosed NPC cases by routine H and E stains were confirmed not to be so by a minimal IHC antibody panel of pan-cytokeratin cocktail (AE1/AE3) and leukocyte common antigen (CD45). This highlights the paramount importance of a minimum IHC panel in assisting to obtain a definitive diagnosis in challenging cases of NPC.
Collapse
Affiliation(s)
- Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Department of Pathology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - James Joseph Yahaya
- Department of Biomedical Science, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
| | | | - Amos Rogers Mwakigonja
- Department of Pathology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.,Department of Pathology, Muhimbili National Hospital, Dar-es-Salaam, Tanzania
| |
Collapse
|
3
|
Mwakigonja AR, Lushina NE, Mwanga A. Characterization of hormonal receptors and human epidermal growth factor receptor-2 in tissues of women with breast cancer at Muhimbili National Hospital, Dar es salaam, Tanzania. Infect Agent Cancer 2017; 12:60. [PMID: 29142588 PMCID: PMC5674811 DOI: 10.1186/s13027-017-0170-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 10/26/2017] [Indexed: 11/10/2022] Open
Abstract
Background Breast cancer is a leading cause of morbidity and deaths among women worldwide. In Tanzania there is no published data on human epidermal growth receptor-2 (HER2/neu) expression in breast carcinoma. Hormonal receptors and HER2/neu status reportedly influence post-mastectomy adjuvant therapy and predict treatment outcome and prognosis. Here we evaluate hormonal receptors and HER-2 status in biopsies of women with breast cancer at Muhimbili National Hospital (MNH). Methods A cross-sectional study of female breast post-modified radical mastectomy (MRM)/incisional biopsies confirmed to be carcinoma at the Histopathology Unit (January–December 2013). Tissue blocks having poor morphology, without tumor, secondary tumors, cases outside the study period and male patients were excluded. Routine staining was done followed by immunohistochemistry for estrogen (ER), and progesterone (PgR) receptors and HER2. Data analyzed using Statistical Package for Social Sciences (SPSS). Results A total of 218 cases were confirmed to be carcinoma including 70 meeting inclusion criteria. Age at diagnosis ranged 18–75 years and mean age was 48.36 years. Majority (64.3%) were in the 36–55 years age-group. Histologically, most (88.6%) women had invasive ductal carcinoma including 43.1% of intermediate grade. A great majority (78%) were stage three. Due to logistical constrains, 75.7% (n = 53/70) cases where immunostained for hormones including 43.4% (ER+), 26.4% (PgR+), and 28% (ER+/PgR+). Furthermore, 65.7% (n = 46/70) cases were immunostained for HER-2 and 15.2% (n = 7/46) were positive, 45.6% were triple negative (ER-,PgR-,HER2-), 23.9% (ER+,PgR+,HER2-) or luminal B, 2.2% (ER+,PgR-,HER2+),13% (ER-,PgR-,HER2+) and 15% (ER+,PgR-,HER2-) with none being triple positive. Conclusions Hormonal receptors and HER2 expression at MNH appears to be comparable to previous Africans/African Americans reports but not with studies among Caucasians and the current proportion of triple negative breast carcinomas (TNBC) is higher than in a previous Tanzanian report and majority are luminal. HER2 over-expression is relatively common. It is strongly recommended that receptor status assessment be made routine for breast cancer patients at MNH.
Collapse
Affiliation(s)
- Amos Rodger Mwakigonja
- Department of Pathology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Nyanda Elias Lushina
- Department of Surgery, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Ally Mwanga
- Department of Surgery, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| |
Collapse
|
4
|
Ndede I, Mining SK, Patel K, Wanjala FM, Chumba D, Tenge C. Cytokines associated with Burkitt's lymphoma in western Kenya. BMC Res Notes 2017; 10:519. [PMID: 29078819 PMCID: PMC5659020 DOI: 10.1186/s13104-017-2841-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/23/2017] [Indexed: 12/26/2022] Open
Abstract
Objective Burkitt’s lymphoma (BL) is a common aggressive non-Hodgkin’s lymphoma in East and Central Africa among children. Persistent infections with Epstein Barr virus or Plasmodium falciparum are associated with immune hyperstimulation. It is hypothesised that inadvertent cytokine responses to infections indirectly or directly influence B cell neoplastic transformation through c-myelocytomatosis (c-myc) gene translocation. We sought to describe cytokines in children and adolescents with BL. Participants were recruited from western Kenya with parental consent, diagnosis confirmed using histology and consensus panel of immunohistochemistry antibodies. T helper1/2/17A and transforming growth factor-β1 (TGF-β1) cytokines were estimated using cytometric bead array in plasma. Complete blood counts (CBC) were determined by Beckman Coulter®. Results Out of 104 enrolled participants, 32% were confirmed BL and 68% grouped as non-BL. Mean (pg/ml) levels of cytokines in BL and non-BL were: interleukin (IL)-6 100.3 and 39.4 p = 0.152; IL-10 11.5 and 12.5 p = 0.363; IL-17A 17.8 and 64.9 p = 0.094 respectively. Expressions of interferon-γ, IL-2 and tumour necrosis factor-α were low and TGF-β1 undetectable in both groups. Mean CBC differed between the two groups before and after chemotherapy, WBC being significantly so. Interleukin-6, IL-17A and IL-10 responses to infections in the study area may be associated with pathogenesis and be potential therapeutic targets.
Collapse
Affiliation(s)
- Isaac Ndede
- Department of Immunology, Moi University School of Medicine, P. O. Box 4606, Eldoret, 30100, Kenya.
| | - Simeon K Mining
- Department of Immunology, Moi University School of Medicine, P. O. Box 4606, Eldoret, 30100, Kenya
| | - Kirtika Patel
- Department of Immunology, Moi University School of Medicine, P. O. Box 4606, Eldoret, 30100, Kenya
| | - Fredrick M Wanjala
- Department of Biological Sciences, University of Eldoret, Eldoret, Kenya
| | - David Chumba
- Department of Histopathology and Cytology, Moi University School of Medicine, Eldoret, Kenya
| | - Constance Tenge
- Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya
| |
Collapse
|
5
|
Perry AM, Perner Y, Diebold J, Nathwani BN, MacLennan KA, Müller-Hermelink HK, Bast M, Boilesen E, Armitage JO, Weisenburger DD. Non-Hodgkin lymphoma in Southern Africa: review of 487 cases from The International Non-Hodgkin Lymphoma Classification Project. Br J Haematol 2015; 172:716-23. [PMID: 26898194 DOI: 10.1111/bjh.13885] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022]
Abstract
Comparative data on the distribution of non-Hodgkin lymphoma (NHL) subtypes in Southern Africa (SAF) is scarce. In this study, five expert haematopathologists classified 487 consecutive cases of NHL from SAF using the World Health Organization classification, and compared the results to North America (NA) and Western Europe (WEU). Southern Africa had a significantly lower proportion of low-grade (LG) B-NHL (34·3%) and a higher proportion of high-grade (HG) B-NHL (51·5%) compared to WEU (54·5% and 36·4%) and NA (56·1% and 34·3%). High-grade Burkitt-like lymphoma was significantly more common in SAF (8·2%) than in WEU (2·4%) and NA (2·5%), most likely due to human immunodeficiency virus infection. When SAF patients were divided by race, whites had a significantly higher frequency of LG B-NHL (60·4%) and a lower frequency of HG B-NHL (32·7%) compared to blacks (22·5% and 62·6%), whereas the other races were intermediate. Whites and other races had a significantly higher frequency of follicular lymphoma and a lower frequency of Burkitt-like lymphoma compared to blacks. The median ages of whites with LG B-NHL, HG B-NHL and T-NHL (64, 56 and 67 years) were significantly higher than those of blacks (55, 41 and 34 years). Epidemiological studies are needed to better understand these differences.
Collapse
Affiliation(s)
- Anamarija M Perry
- Department of Pathology, University of Manitoba, Winnipeg, MB, Canada
| | - Yvonne Perner
- Division of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
| | - Jacques Diebold
- Department of Anatomic Pathology and Cytology, Hotel-Dieu, University Denis Diderot, Paris, France
| | - Bharat N Nathwani
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Kenneth A MacLennan
- Section of Pathology and Leeds Institute of Molecular Medicine, St. James University Hospital, Leeds, UK
| | | | - Martin Bast
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Eugene Boilesen
- Center for Collaboration on Research, Design and Analysis, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - James O Armitage
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | | |
Collapse
|
6
|
CT before lumbar puncture in suspected meningitis in Botswana: How established guidelines may not apply. Afr J Emerg Med 2014. [DOI: 10.1016/j.afjem.2013.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
7
|
Naresh KN, Raphael M, Ayers L, Hurwitz N, Calbi V, Rogena E, Sayed S, Sherman O, Ibrahim HAH, Lazzi S, Mourmouras V, Rince P, Githanga J, Byakika B, Moshi E, Durosinmi M, Olasode BJ, Oluwasola OA, Akang EE, Akenòva Y, Adde M, Magrath I, Leoncini L. Lymphomas in sub-Saharan Africa--what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research? Br J Haematol 2011; 154:696-703. [PMID: 21707579 DOI: 10.1111/j.1365-2141.2011.08772.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Approximately 30 000 cases of non-Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing in this part of the world, very little is known about lymphomas in Africa. This review provides information regarding the current infrastructure for diagnostics in sub-Saharan Africa. The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub-Saharan Africa were based on a review undertaken by a team of lymphoma experts on 159 fine needle aspirate samples and 467 histological samples during their visit to selected sub-Saharan African centres is presented. Among children (<18 years of age), BL accounted for 82% of all NHL, and among adults, diffuse large B-cell lymphoma accounted for 55% of all NHLs. Among adults, various lymphomas other than BL, including T-cell lymphomas, were encountered. The review also discusses the current strategies of the International Network of Cancer Treatment and Research on improving the diagnostic standards and management of lymphoma patients and in acquiring reliable clinical and pathology data in sub-Saharan Africa for fostering high-quality translational research.
Collapse
Affiliation(s)
- Kikkeri N Naresh
- Hammersmith Hospital & Imperial College, London, UKUniv Paris-Sud, Paris, FranceThe Ohio State University, Columbus, Ohio, USAUniversity of Basel, Basel, SwitzerlandSaint Mary Hospital, Lacor, Gulu, UgandaUniversity of NairobiAga Khan University Hospital, Nairobi, KenyaMansoura University, Mansoura, EgyptUniversity of Siena, Siena, ItalyNairobi Hospital, Nairobi, Kenya; Nairobi, KenyaMuhimbili National Hospital, Dares salaam, TanzaniaObafemi Awolowo University, Ile Ife, NigeriaU.C.H, Ibadan, NigeriaINCTR, Brussels, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Predictors of survival after a diagnosis of non-Hodgkin lymphoma in a resource-limited setting: a retrospective study on the impact of HIV infection and its treatment. J Acquir Immune Defic Syndr 2011; 56:312-9. [PMID: 21350364 DOI: 10.1097/qai.0b013e31820c011a] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We examined factors associated with survival among patients with newly diagnosed non-Hodgkin lymphoma (NHL) in Uganda. METHODS Information was abstracted from medical records for all NHL patients >13 years of age at the Uganda Cancer Institute between January 2004 and August 2008. Cox proportional hazard models were used to identify predictors of NHL survival. RESULTS One hundred sixty patients with NHL were identified; 51 (31.9%) were known to be HIV positive. Overall, 154 patients had records sufficient for further analysis. The median person-time observed was 104 days (interquartile range 26-222). Median survival after presentation among those whose mortality status was confirmed was 61 days (interquartile range 25-203). HIV-positive patients receiving antiretroviral therapy had survival rates approximating those of HIV-negative persons, but the adjusted hazard of death was significantly elevated among HIV-positive patients not receiving antiretroviral therapy [adjusted hazard ratio (HR) 8.99, P < 0.001] compared with HIV-negative patients. Both B-symptoms (HR 2.08, P = 0.05) and female gender (HR 1.72, P = 0.05) were associated with higher mortality. CONCLUSIONS In Uganda, overall survival of NHL patients is poor, and predictors of survival differed from those described in resource-rich regions. HIV is a common comorbidity to NHL, and its lack of treatment was among the strongest predictors of mortality. Strategies are needed for optimal management of HIV-infected individuals with cancer in resource-limited settings.
Collapse
|
9
|
Kamulegeya A, Muwazi L, Kasaganki A, Rwenyonyi C, Kuteesa A. Trends in Burkitt's lymphoma: a three-decade retrospective study from Uganda. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1752-248x.2010.01095.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
|
11
|
Mwakigonja AR, Kaaya EE, Heiden T, Wannhoff G, Castro J, Pak F, Porwit A, Biberfeld P. Tanzanian malignant lymphomas: WHO classification, presentation, ploidy, proliferation and HIV/EBV association. BMC Cancer 2010; 10:344. [PMID: 20591198 PMCID: PMC2909982 DOI: 10.1186/1471-2407-10-344] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2009] [Accepted: 07/01/2010] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In Tanzania, the International Working Formulation [WF] rather than the WHO Classification is still being used in diagnosing malignant lymphomas (ML) and the biological characterization including the HIV/EBV association is sketchy, thus restraining comparison, prognostication and application of established therapeutic protocols. METHODS Archival, diagnostic ML biopsies (N = 336), available sera (N = 35) screened by ELISA for HIV antibodies and corresponding clinical/histological reports at Muhimbili National Hospital (MNH) in Tanzania between 1996 and 2006 were retrieved and evaluated. A fraction (N = 174) were analyzed by histopathology and immunohistochemistry (IHC). Selected biopsies were characterized by flow-cytometry (FC) for DNA ploidy (N = 60) and some by in-situ hybridization (ISH) for EBV-encoded RNA (EBER, N = 37). RESULTS A third (38.8%, 109/281) of the ML patients with available clinical information had extranodal disease presentation. A total of 158 out of 174 biopsies selected for immunophenotyping were confirmed to be ML which were mostly (84. 8%, 134/158) non-Hodgkin lymphoma (NHL). Most (83.6%, 112/134) of NHL were B-cell lymphomas (BCL) (CD20+), of which 50.9%, (57/112) were diffuse large B-cell (DLBCL). Out of the 158 confirmed MLs, 22 (13.9%) were T-cell [CD3+] lymphomas (TCL) and 24 (15.2%) were Hodgkin lymphomas (HL) [CD30+]. Furthermore, out of the 60 FC analyzed ML cases, 27 (M:F ratio 2:1) were DLBCL, a slight majority (55.6%, 15/27) with activated B-cell like (ABC) and 45% (12/27) with germinal center B-cell like (GCB) immunophenotype. Overall, 40% (24/60) ML were aneuploid mostly (63.0%, 17/27) the DLBCL and TCL (54.5%, 6/11). DNA index (DI) of FC-analyzed ML ranged from 1.103-2.407 (median = 1.51) and most (75.0%) aneuploid cases showed high (>40%) cell proliferation by Ki-67 reactivity. The majority (51.4%, 19/37) of EBER ISH analyzed lymphoma biopsies were positive. Of the serologically tested MLs, 40.0% (14/35) were HIV positive, mostly with high (> or =40.0%) Ki-67 reactivity. CONCLUSIONS According to the 2001 WHO Classification, most subtypes are represented in Tanzanian ML. Extranodal presentation was common among MNH lymphoma patients who also showed high aneuploidy, tumor proliferation (KI-67) and EBER positivity. DLBCL was frequent and phenotype heterogeneity appeared similar to observations in Western countries suggesting applicability of established intervention approaches. HIV was apparently associated with high ML cell proliferation but extended studies are needed to clarify this.
Collapse
Affiliation(s)
- Amos R Mwakigonja
- Cancer Center Karolinska, Department of Oncology-Pathology, Karolinska University Hospital Solna/Karolinska Institute, Stockholm, Sweden.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
|
13
|
New developments in the pathology of malignant lymphoma: a review of the literature published from May to July 2008. J Hematop 2009; 1:145-60. [PMID: 19669214 PMCID: PMC2713479 DOI: 10.1007/s12308-008-0012-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
|