Prognostic Factors of Non-Hodgkin Lymphoma: Retrospective Study in Unit Blood Service of the Internal Medicine Dantec in Dakar (Senegal)

Abstract

INTRODUCTION: The non-Hodgkin's lymphoma is the monoclonal proliferation of B and T lymphocyte cells, responsible for the development of tumors in lymphoid organs. The objective of this study was to describe the prognostic factors for NHL and their impact in the care of patients METHODOLOGY: This is a descriptive retrospective study on patients hospitalized files Medical Clinic I of the Aristide Le Dantec Hospital from January 2005 to December 2009. Were included in the study, patients for whom diagnosis of non-Hodgkin lymphoma was made on the basis of the results of histological and / or immuno-phenotypic examination of the biopsy specimen. Prognostic factors were studied and classified according to the prognostic scores in order to assess their impact on patient survival. Data analysis was done thanks to the IPSS software and the significance level was set at p ≤ 5%. RESULTS: NHL 44 cases represented on all patients hospitalized for haematological malignancies during this period, a prevalence of 45.4%. We have noted an increase in the incidence of NHL 2005 to 2009. The sex ratio was 2.6 / 1 and the mean age was 46.77 years [17-78 years]. Among the general symptoms, fever and weight loss were in the forefront (61.4% of patients) and lymph nodes were the most frequent physical signs (75%) followed by splenomegaly (47.7%). anemia was found in 72.7% of cases, leukocytosis in 45.5% of cases and thrombocytopenia in 47.7% of patients. Thirty-seven point four percent of patients were classified stage IV Ann Arbor at diagnosis. The presence of general signs scalability B was observed in 70% of patients. Regarding the prognostic factors, the International Prognostic Index (IPI) was studied in 43.2% of patients (n = 19) patients showed that 16% (n = 3) were IPI 1; 37% (n = 7) had an intermediate risk (IPI 3 and 4) and the remaining 10% were high risk (IPI 4). The IPI adjusted for age (aaIPI), noted a correlation of the IPI with certain age groups (50 and 60 years, p = 0.00001, 60 and 70, p = 0.00001). All patients were classified LLC Binet stage C and FLIPI was low (1-2). Evolution were marked by a 100% survival for low-risk patients (with a statistically significant correlation between survival and IPI 1: p <0.00001) and a death rate of 100% for high-risk patients (p <0.00001). The evolution was marked by a prolonged clinical and laboratory remission in 61.3% of cases, 11.4% of patients lost to 27.4% of deceased patients.

Diagnosis and Follow Up of Non Hodgkin Lymphoma in Dakar, Senegal

“…This very significant clinical course was reported by Ndiaye et al [1] who described 75% of patients with polyadenopathy. This could be related to the delay in diagnosis experienced by our patients.…”

“…In Côte d'Ivoire, Tolo [10] found a mortality rate of 36.16% and Sawadogo [11] reported a death rate of 44%. Ndiaye [1] in Senegal found a mortality rate of 27.4% in his study. This relatively high mortality rate could be related to an advanced prognosis at the time of diagnosis.…”

“…In Senegal, a remarkable increase in incidence has been observed. Their prevalence among haematological malignancies rose from 25.6% to 45.4% between 1998 and 2009 [1]. Their management is costly and usually not within the reach of patients.…”

Diagnosis and Follow-up of Non-Hodgkin Lymphoma in Dakar, Senegal

“…There was no difference in survival according to gender, locality, occupation, delay before consultation or diagnosis (p greater than 0.5). This very significant clinical course was reported by Ndiaye., et al [1] who described 75% of patients with polyadenopathy. This could be related to the delay in diagnosis experienced by our patients.…”