Frequency, Distribution of Subtypes and Immunohistochemical Profile of Non-Hodgkin Lymphoma in Paediatric and Adolescent Patients

Abstract

Background: Non-Hodgkin lymphoma is a common malignant disorder in paediatric and adolescent age group. There is a need of large-scale studies to understand the disease pattern in Pakistan as no official registry exist in most of the developing countries. This study comprised a large cohort of 223 patients, spanned over a decade from January 2008-December 2019 and aimed to report the prevalence of subtypes, demographics and immunohistochemical profile from this region. Methods: Retrospective study, conducted at Indus hospital and health network and Ziauddin university hospital, Karachi, Pakistan. Sequential data analysis was carried out on all consecutive samples including both needle and excisional biopsies of patients below 18 years of age. Morphological examination of H&E stained sections along with immunohistochemistry is performed in order to identify subtypes and immunophenotypic patterns using an extensive panel of markers. Results: Our results demonstrate 66% B-cell lymphomas while 34% T-cell lymphomas. Overall male to female ratio was 3.3:1 with median age 8 years (1.1–17 years). Among B-cell lymphoma, Burkitt lymphoma is most common while in T-cell, T-lymphoblastic lymphoma is the most common subtype. In anaplastic large cell lymphoma category, null cell phenotype was predominant, i.e., 65%. T-NHL frequency is found to be higher in our population. However, results of immunohistochemistry are similar to published literature. Conclusion: The study will help to identify disease patterns in terms of subtypes of NHL and its immunohistochemical profile that plays a vital role in diagnostic, prognostic and therapeutic implications.

Frequency and Reasons for Vaccination Failure against Measles among Pediatric Cases at a Tertiary Care Hospital of Karachi

“…This predominance of male gender is in keeping with results of multiple studies including a meta-analysis of data from seven countries which revealed a significantly higher frequency of measles in male varying from 50.6% to 52.9%. [8][9][10] The mean age of the patients in our research was 2.2 years, while the age group affected most was 1 to 5 years in 52.4% of cases. Same results were found in another local study by the same principal investigator which documented that the mean age of measles patients was 32.82 months (2.7 years) and most of the cases belonged to age group 10 to 24 months.…”

“…Same results were found in another local study by the same principal investigator which documented that the mean age of measles patients was 32.82 months (2.7 years) and most of the cases belonged to age group 10 to 24 months. 8 A very surprising result in our research was the fact that 80% of the measles patients had received measles vaccine, raising doubts on its efficacy. Although this result is supported by an investigation in an elementary school of Alabama showing that 68% of the measles patients were vaccinated, 11 most of the literature has documented a negative correlation of measles infection with the vaccination status.…”

“…A few years back, the same author has reported 18% of measles cases below the age of routine vaccination including 1.8% ≤6 months of age. 8 Data from the United States also show 13% of measles cases before the age of 12 months, that is, eligibility for vaccination. 22 This fact needs further exploration and suggests the need for shifting of the first dose of measles at an earlier age.…”

“…This predominance of male gender is in keeping with results of multiple studies including a meta-analysis of data from seven countries which revealed a significantly higher frequency of measles in male varying from 50.6% to 52.9%. 8 9 10…”

“…Same results were found in another local study by the same principal investigator which documented that the mean age of measles patients was 32.82 months (2.7 years) and most of the cases belonged to age group 10 to 24 months. 8…”