Hodgkin Lymphoma in Nigeria: Prevalence, Mechanisms of Tumorigenesis and Diagnosis

Abstract

Hodgkin lymphoma (HL) is an uncommon neoplasm where tumor stems from a certain kind of leukocytes known as B-cell. This lymphoid malignancy involves outlying lymph gland which may extend to tissues. Research estimates 40% of patients are diagnosed from constitutive signs while early detection is a challenge. The Hodgkin Reed-Stenberg cells is established as the hallmark of Hodgkin lymphoma but multiple underlying mechanisms are involved. Hodgkin lymphoma spreads across different regions with limitations of effective control, hence there is a need to fully understand its tumorigenesis and diagnosis. We reviewed the multiphase deregulated signalling pathways and several interactions amongst cells, these characteristics can proffer new breakthrough to target therapeutics either through direct inhibition of affected signalling pathways or Hodgkin Reed-Stenberg cells associated with diverse cellular infiltrates within the lymph cell. HL incidence in Nigeria is similar to the incidence in other regions but there is a higher death rate in Nigeria. Nigeria bears the second highest burden of HIV globally which contributes to incidence of HL. Also, Epstein-Barr virus increases the risk of the disease, which is also prevalent in Nigeria. Lymphomas are associated with higher cancer-related deaths especially in HIV-infected persons with 2.5times lower 2-year survival chance compared to HIV-uninfected persons and late stage of lymphoma was also a contributing factor to the survival outcomes. Hence, to reduce the burden of the disease, an understanding of the aetiology, epidemiology, and biochemical mechanisms of the lymphoma is needed which are herein reviewed.