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Frequency and Pattern of Bone Marrow Infiltration in Classical Hodgkin's Lymphoma: Experience from Southern Pakistan

  • Sultan, Sadia (Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College) ;
  • Irfan, Syed Mohammed (Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College) ;
  • Parveen, Saira (Department of Hematology and Blood Bank, Liaquat National Hospital and Medical College) ;
  • Haider, Syeda Amna (Liaquat National Medical College) ;
  • Masood, Mahira (Liaquat National Medical College)
  • 발행 : 2016.06.01

초록

Background: Hodgkin's lymphoma (formerly, Hodgkins disease) is a potentially curable malignancy with distinctive biological behavior and specific clinical characteristics. Limited information is available from developing countries for patients with classical Hodgkin's lymphoma (cHL). Therefore we reviewed the demographical and clinico-hematological profiles along with bone marrow infiltration patterns in adult patients presenting at Liaquat National Hospital and Medical College. Materials and Methods: In this cross sectional study, 62 adult (${\geq}15years$) patients with cHL were enrolled from January 2010 to December 2014. Results: The mean age was $29.7{\pm}13.8years$ with a median of 30 years. The male to female ratio was 2:1. B symptoms were present in 72.5% of patients and lymph node enlargement in 85.4%. The frequency of bone marrow infiltration in our cHL patients was found to be 27.4%, the pattern being predominantly focal followed by diffuse. The mean hemoglobin was $9.4{\pm}1.9g/dl$ with a mean MCV of $78.1{\pm}7.9fl$, a mean total leukocyte count of $10.9{\pm}20.6{\times}10^9/l$ and a mean platelet count of $241.6{\pm}150.1{\times}10^9/l$. Conclusions: Our analysis shows that clinico-pathological features of cHL in Pakistan are comparable to published data. Peripheral lymphodenopathy associated with B symptoms is the commonest presentation. Bone marrow involvement is more common in our setup as patients usually presented at an advanced stage of disease.

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참고문헌

  1. Ansell SM (2015). Hodgkin lymphoma: diagnosis and treatment. Mayo Clin Proc, 90, 1574-83. https://doi.org/10.1016/j.mayocp.2015.07.005
  2. Butt F, Akhtar R, Rahmani T, et al (2002). Bone marrow involvement in lymphoma: Incidence and co-relation with age and sex. Biomedica, 18, 53-7.
  3. Cartwright RA, Watkins G (2004). Epidemiology of Hodgkin’s disease: a review. Hematol Oncol, 22, 11-26. https://doi.org/10.1002/hon.723
  4. Cheong JW, Park SY, Roh JK, et al (2006). Treatment of Hodgkin's disease: a twenty-year follow-up of patients at a center in Korea. Yonsei Med J, 47, 455-65. https://doi.org/10.3349/ymj.2006.47.4.455
  5. Fatima S, Ahmed R, Ahmed A (2011). Hodgkin lymphoma in Pakistan: an analysis of subtypes and their correlation with Epstein Barr virus. Asian Pac J Cancer Prev, 12, 1385-8.
  6. Franco V, Tripodo C, Rizzo A, et al (2004). Bone marrow biopsy in Hodgkin’s lymphoma. Eur J Haematol, 73, 149-55. https://doi.org/10.1111/j.1600-0609.2004.00292.x
  7. Ganesan P, Kumar L, Raina V (2011). Hodgkin’s lymphomalong- term outcome: an experience from a tertiary care cancer center in North India. Ann Hematol, 90, 1153-60. https://doi.org/10.1007/s00277-011-1262-8
  8. Gad Allah H, El-Azzazi MO, Elafifi AM, et al (2014). Treatment outcome in Egyptian lymphoma patients, 2-year results, single-center experience. Egypt J Haematol, 39, 209-16. https://doi.org/10.4103/1110-1067.153957
  9. Hasenclever D, Diehl V (1998). A prognostic score for advanced Hodgkin's disease. international prognostic factors project on advanced hodgkin’s disease. N Engl J Med, 339, 1506-14. https://doi.org/10.1056/NEJM199811193392104
  10. Hamid A, Hamid Am, Jabbar N, et al (2010). Significance of bone marrow biopsy in staging of Hodgkin’s lymphoma. Ann King Edward Med University, 16, 12-16.
  11. Howell SJ, Grey M, Chang J, et al (2002). The value of bone marrow examination in the staging of Hodgkin’s lymphoma: a review of 955 cases seen in a regional cancer centre. Br J Haematol, 119, 408-11. https://doi.org/10.1046/j.1365-2141.2002.03842.x
  12. Jarrett AF, Armstrong AA, Alexander E (1996). Epidemiology of EBV and Hodgkin’s lymphoma. Ann Oncol, 7, 45-10. https://doi.org/10.1093/annonc/7.suppl_5.45
  13. Kilickap S, Barışta I, Ulger S, et al (2013). Clinical features and prognostic factors of hodgkin’s lymphoma: a single center experience. Balkan Med J, 30, 178-85. https://doi.org/10.5152/balkanmedj.2012.110
  14. Li X, Yang SE, Guo YQ, et al (2012). Clinical significance of quantitative analysis of plasma epstein- barr virus DNA in patients of Xinjiang Uygur nationality with Hodgkin’s Lymphoma. Asian Pac J Cancer Prev, 13, 6379-84. https://doi.org/10.7314/APJCP.2012.13.12.6379
  15. Levis A, Pietrasanta D, Godio L, et al (2004). A large-scale study of bone marrow involvement in patients with Hodgkin’s lymphoma. Clin Lymphoma, 5, 50-5. https://doi.org/10.3816/CLM.2004.n.010
  16. Lone A, Naeem S (2011). Frequency and pattern of bone marrow infiltration in Hodgkin’s Lymphoma. Biomedica, 27, 132-5.
  17. Roshandel G, Semnani S, Aarabi M, et al (2011). Lymphomas in Golestan province of Iran: results of a population-based cancer registry. Asian Pac J Cancer Prev, 12, 219-22.
  18. Sader-Ghorra C, Rassy M, Naderi S, et al (2014).Type distribution of lymphomas in Lebanon: five-year single institution experience. Asian Pac J Cancer Prev, 15, 5825-8. https://doi.org/10.7314/APJCP.2014.15.14.5825
  19. Shankar AG, Ashley S, Radford M, et al (1997). Does histology influence outcome in childhood Hodgkin’s disease? Results from the United Kingdom Children’s Cancer Study Group. J Clin Oncol, 15, 2622-30. https://doi.org/10.1200/JCO.1997.15.7.2622
  20. Siddiqui N, Ayub B, Badar F, et al (2006). Hodgkin’s lymphoma in Pakistan: a clinico-epidemiological study of 658 cases at a cancer center in Lahore. Asian Pac J Cancer Prev, 7, 651-5.
  21. Smith A, Crouch S, Lax S,et al (2015). Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK’s haematological malignancy research network. Br J Cancer, 112, 1575-84. https://doi.org/10.1038/bjc.2015.94
  22. Sive J, Linch D (2011). Hodgkin lymphoma. In:Hoffbrand AV, Catovsky D, Tuddenham EG, Green AR. Post graduate hematology, 6th edition, 639.
  23. Swerdlow SH, Campo E, Harris NL, et al (2008). WHO Classification of Tumors: Pathology and Genetics of Tumors of Haematopoietic and Lymphoid Tissues. Lyon: IARC Press, 321-34.
  24. Tang Y, Sun LG, Liu CS, et al (2013). Clinical analysis of stages of HBV infection in 100 cases of lymphoma. Asian Pac J Cancer Prev, 14, 959-62. https://doi.org/10.7314/APJCP.2013.14.2.959
  25. Vassallo J, Paes RP, Soares FA, et al (2005). Histological classification of 1,025 cases of Hodgkin’s lymphoma from the State of São Paulo, Brazil. Sao Paulo Med J, 123, 134-6. https://doi.org/10.1590/S1516-31802005000300009