Tumwine Lynnette K, Agostinelli Claudio, Campidelli Cristina, Othieno Emmanuel, Wabinga Henry, Righi Simona, Falini Brunangelo, Piccaluga Pier Paolo, Byarugaba Wilson, Pileri Stefano A
Department of Pathology, Makerere University, College of Health Sciences, PO Box 7072, Kampala, Uganda.
BMC Clin Pathol. 2009 Dec 16;9:11. doi: 10.1186/1472-6890-9-11.
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.
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.
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).
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.
非霍奇金淋巴瘤是乌干达最常见的淋巴瘤。发达国家的近期研究表明，不同免疫表型的生存率存在差异。在非洲，此类研究较为缺乏，因为那里的诊断很大程度上仅依赖于形态学。我们报告了乌干达坎帕拉B细胞非霍奇金淋巴瘤患者的免疫组化及其他预后因素。
从乌干达坎帕拉马凯雷雷大学健康科学学院病理学系1991年至2000年的档案中获取非霍奇金淋巴瘤组织块，使用苏木精和伊红、吉姆萨以及免疫组化进行亚型分类。利用组织微阵列，对119份活检标本进行以下检测：CD3、CD5、CD10、CD20、CD23、CD30、CD38、CD79a、CD138、Bcl-6、Bcl-2、IRTA-1、MUM1/IRF4、Bcl-1/细胞周期蛋白D1、TdT、ALKc和Ki-67/Mib1。检索病例记录以获取疾病分期、接受的化疗疗程，并进行生存情况的回顾性随访。
非霍奇金B细胞淋巴瘤包括伯基特淋巴瘤BL、弥漫性大B细胞淋巴瘤(19/119)、套细胞淋巴瘤(4/119)和前体B淋巴母细胞淋巴瘤(1/119)。对于伯基特淋巴瘤，良好的预后与接受化疗、女性性别和CD30阳性相关。经过Cox回归分析后，仅接受化疗仍然具有显著意义。具有活化生发中心B细胞(GCB)模式(CD10+/-、BCL-6+/-、MUM+/-、CD138+/-)的弥漫性大B细胞淋巴瘤的生存期(98.4个月；95%CI 89.5 - 107.3)优于其他类型(57.3个月；95%CI 35.5 - 79.0)，p = 0.027(对数秩检验)。
活化GCB弥漫性大B细胞淋巴瘤的预后优于其他类型。对于伯基特淋巴瘤，未接受化疗的预后较差。在这种资源有限的环境中，化疗的可及性对淋巴瘤患者的生存至关重要。
