Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
African Cancer Registry Network, Oxford, UK.
Br J Haematol. 2020 Jul;190(2):209-221. doi: 10.1111/bjh.16575. Epub 2020 Mar 17.
Non-Hodgkin lymphoma (NHL) is the sixth most common cancer in Sub-Saharan Africa (SSA). Comprehensive diagnostics of NHL are essential for effective treatment. Our objective was to assess the frequency of NHL subtypes, disease stage and further diagnostic aspects. Eleven population-based cancer registries in 10 countries participated in our observational study. A random sample of 516 patients was included. Histological confirmation of NHL was available for 76.2% and cytological confirmation for another 17.3%. NHL subclassification was determined in 42.1%. Of these, diffuse large B cell lymphoma, chronic lymphocytic leukaemia and Burkitt lymphoma were the most common subtypes identified (48.8%, 18.4% and 6.0%, respectively). We traced 293 patients, for whom recorded data were amended using clinical records. For these, information on stage, human immunodeficiency virus (HIV) status and Eastern Cooperative Oncology Group Performance Status (ECOG PS) was available for 60.8%, 52.6% and 45.1%, respectively. Stage at diagnosis was advanced for 130 of 178 (73.0%) patients, HIV status was positive for 97 of 154 (63.0%) and ECOG PS was ≥2 for 81 of 132 (61.4%). Knowledge about NHL subclassification and baseline clinical characteristics is crucial for guideline-recommended treatment. Hence, regionally adapted investments in pathological capacity, as well as standardised clinical diagnostics, will significantly improve the therapeutic precision for NHL in SSA.
在撒哈拉以南非洲（SSA），非霍奇金淋巴瘤（NHL）是第六大常见癌症。对 NHL 进行全面诊断对于有效治疗至关重要。我们的目标是评估 NHL 亚型、疾病分期和进一步诊断方面的频率。来自 10 个国家的 11 个人口肿瘤登记处参与了我们的观察性研究。纳入了一个随机的 516 名患者样本。76.2%的患者进行了 NHL 的组织学确认，另有 17.3%的患者进行了细胞学确认。42.1%的患者进行了 NHL 亚型分类。其中，弥漫性大 B 细胞淋巴瘤、慢性淋巴细胞白血病和伯基特淋巴瘤是最常见的亚型（分别为 48.8%、18.4%和 6.0%）。我们追踪了 293 名患者，使用临床记录对记录的数据进行了修正。对于这些患者，可获得分期、人类免疫缺陷病毒（HIV）状态和东部合作肿瘤学组表现状态（ECOG PS）的信息分别为 60.8%、52.6%和 45.1%。178 名患者中有 130 名（73.0%）患者诊断时分期较晚，154 名患者中有 97 名（63.0%）HIV 阳性，132 名患者中有 81 名（61.4%）ECOG PS≥2。对 NHL 亚型分类和基线临床特征的了解对于推荐治疗方案至关重要。因此，在病理能力方面进行区域适应性投资，并标准化临床诊断，将显著提高 SSA 地区 NHL 的治疗精度。
