Clinico-pathologic Profile and Treatment Outcome of Children with Non-Hodgkin’s Lymphoma seen at Hemato-oncologic unit ,Tikur Anbessa Specialized Hospital, Addis Ababa ,Ethiopia.
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Date
2021-11
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Addis Abeba University
Abstract
Background: Lymphoma is general term for cancers that develop in the lymphatic system and is
the third most common childhood mali gnancy. It is classified into two broad categories, different
mani festations and treatment approach: Hodgki n and non-Hodgkin l ymphoma. Non- Hodgki n
lymphoma accounts for approxi mately 60% of all lymphomas in children and adolescents with a
hi gher incidence in sub-Saharan African (SSA) countries. With the current modality of
treatment, localized NHL (stage I to II) has an approxi mate 95% to 100% 5-year event-free
survival (EFS) and more than 80% for children with advanced-stage disease (stage III to IV).
Despite the increasing burden, i nfrastructure for diagnosis and treatment of hematolymphoid
mali gnancies remains inadequate i n SSA. To our knowledge there is no study done in Ethiopia
on NHL survival.
Objective: To assess the clinico-pathologic profile and treatment outcome of children with NonHodgki
n’s Lymphoma who sought care at pediatric oncology unit i n Ti kur Anbessa Specialized
Hospital (TASH).
Method: We conducted a hospital-based retrospective cross sectional study at the pediatric
oncology uni t at TASH. The study period was from Jul y 1st to August 31st, 2021. Data of 149
children who meet the i nclusion criteria were analyzed using Statistical Package for Social
Sciences (SPSS) version 25. We conducted both descriptive and anal ytical statistics. We run Chi
square test, Log Rank test and Cox regression to assess association among the variables of
interest. Kaplan Meier esti mates were used for five-year overall survival analysis. P-values of
<0.05 were considered statistically significant differences or association.
Result: Most (44.3%) childhood cases of NHL occurred between five to ten years of age, more
commonl y affecti ng males than females (2.38:1 ratio). More than half of the patients presented
with advanced stage and commonest presentation is abdominal swelling. Burkitts lymphoma is
the commonest histologic type. Advanced disease stage is signi ficantl y associated with low
hemoglobin level, high LDH and older age.. In this study we did not find signi ficant differences
in the EFS rate by different prognostically relevant variables. The five year OS was 66.5% and
EFS was 63.1%.
Conclusion Five year over all and event free survival for childhood NHL at TASH is lower
than what has been reported elsewhere including the average i n developing countries.
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Keywords
Lymphoma,children