Non-hodgkin lymphoma in the developing world

Review of 4539 cases from the international Non-Hodgkin Lymphoma Classification Project

Anamarija M. Perry, Jacques Diebold, Bharat N. Nathwani, Kenneth A. Maclennan, Hans K. Müller-Hermelink, Martin Bast, Eugene Boilesen, James Olen Armitage, Dennis D. Weisenburger

Research output: Contribution to journalArticle

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Abstract

The distribution of non-Hodgkin lymphoma subtypes varies around the world, but a large systematic comparative study has never been done. In this study, we evaluated the clinical features and relative frequencies of non-Hodgkin lymphoma subtypes in five developing regions of the world and compared the findings to the developed world. Five expert hematopathologists classified 4848 consecutive cases of lymphoma from 26 centers in 24 countries using the World Health Organization classification, and 4539 (93.6%) were confirmed to be non-Hodgkin lymphoma, with a significantly greater number of males than females in the developing regions compared to the developed world (P<0.05). The median age at diagnosis was significantly lower for both low- and high-grade B-cell lymphoma in the developing regions. The developing regions had a significantly lower frequency of B-cell lymphoma (86.6%) and a higher frequency of T- and natural killer-cell lymphoma (13.4%) compared to the developed world (90.7% and 9.3%, respectively). Also, the developing regions had significantly more cases of high-grade B-cell lymphoma (59.6%) and fewer cases of low-grade B-cell lymphoma (22.7%) compared to the developed world (39.2% and 32.7%, respectively). Among the B-cell lymphomas, diffuse large B-cell lymphoma was the most common subtype (42.5%) in the developing regions. Burkitt lymphoma (2.2%), precursor B- and T-lym-phoblastic leukemia/lymphoma (1.1% and 2.9%, respectively) and extranodal natural killer/T-cell lymphoma (2.2%) were also significantly increased in the developing regions. These findings suggest that differences in etiologic and host risk factors are likely responsible, and more detailed epidemiological studies are needed to better understand these differences.

Original languageEnglish (US)
Pages (from-to)1244-1250
Number of pages7
JournalHaematologica
Volume101
Issue number10
DOIs
StatePublished - Sep 30 2016
Externally publishedYes

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B-Cell Lymphoma
Non-Hodgkin's Lymphoma
Lymphoma
Natural Killer T-Cells
Burkitt Lymphoma
Lymphoma, Large B-Cell, Diffuse
T-Cell Lymphoma
Epidemiologic Studies
Leukemia

ASJC Scopus subject areas

  • Hematology

Cite this

Perry, A. M., Diebold, J., Nathwani, B. N., Maclennan, K. A., Müller-Hermelink, H. K., Bast, M., ... Weisenburger, D. D. (2016). Non-hodgkin lymphoma in the developing world: Review of 4539 cases from the international Non-Hodgkin Lymphoma Classification Project. Haematologica, 101(10), 1244-1250. https://doi.org/10.3324/haematol.2016.148809

Non-hodgkin lymphoma in the developing world : Review of 4539 cases from the international Non-Hodgkin Lymphoma Classification Project. / Perry, Anamarija M.; Diebold, Jacques; Nathwani, Bharat N.; Maclennan, Kenneth A.; Müller-Hermelink, Hans K.; Bast, Martin; Boilesen, Eugene; Armitage, James Olen; Weisenburger, Dennis D.

In: Haematologica, Vol. 101, No. 10, 30.09.2016, p. 1244-1250.

Research output: Contribution to journalArticle

Perry, AM, Diebold, J, Nathwani, BN, Maclennan, KA, Müller-Hermelink, HK, Bast, M, Boilesen, E, Armitage, JO & Weisenburger, DD 2016, 'Non-hodgkin lymphoma in the developing world: Review of 4539 cases from the international Non-Hodgkin Lymphoma Classification Project', Haematologica, vol. 101, no. 10, pp. 1244-1250. https://doi.org/10.3324/haematol.2016.148809
Perry, Anamarija M. ; Diebold, Jacques ; Nathwani, Bharat N. ; Maclennan, Kenneth A. ; Müller-Hermelink, Hans K. ; Bast, Martin ; Boilesen, Eugene ; Armitage, James Olen ; Weisenburger, Dennis D. / Non-hodgkin lymphoma in the developing world : Review of 4539 cases from the international Non-Hodgkin Lymphoma Classification Project. In: Haematologica. 2016 ; Vol. 101, No. 10. pp. 1244-1250.
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abstract = "The distribution of non-Hodgkin lymphoma subtypes varies around the world, but a large systematic comparative study has never been done. In this study, we evaluated the clinical features and relative frequencies of non-Hodgkin lymphoma subtypes in five developing regions of the world and compared the findings to the developed world. Five expert hematopathologists classified 4848 consecutive cases of lymphoma from 26 centers in 24 countries using the World Health Organization classification, and 4539 (93.6{\%}) were confirmed to be non-Hodgkin lymphoma, with a significantly greater number of males than females in the developing regions compared to the developed world (P<0.05). The median age at diagnosis was significantly lower for both low- and high-grade B-cell lymphoma in the developing regions. The developing regions had a significantly lower frequency of B-cell lymphoma (86.6{\%}) and a higher frequency of T- and natural killer-cell lymphoma (13.4{\%}) compared to the developed world (90.7{\%} and 9.3{\%}, respectively). Also, the developing regions had significantly more cases of high-grade B-cell lymphoma (59.6{\%}) and fewer cases of low-grade B-cell lymphoma (22.7{\%}) compared to the developed world (39.2{\%} and 32.7{\%}, respectively). Among the B-cell lymphomas, diffuse large B-cell lymphoma was the most common subtype (42.5{\%}) in the developing regions. Burkitt lymphoma (2.2{\%}), precursor B- and T-lym-phoblastic leukemia/lymphoma (1.1{\%} and 2.9{\%}, respectively) and extranodal natural killer/T-cell lymphoma (2.2{\%}) were also significantly increased in the developing regions. These findings suggest that differences in etiologic and host risk factors are likely responsible, and more detailed epidemiological studies are needed to better understand these differences.",
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