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

Abstract

Introduction: The management of Non-Hodgkin Lymphoma (NHL) in Senegal is challenging due to the lack of exploration tools and the inaccessibility of anticancer drugs. This study aimed to identify the prognostic factors at diagnosis and to assess their outcome under treatment. Methodology: We conducted a descriptive and analytical prospective study range from 1st January 2018 to 3rd July 2020 covering NHL cases. Initial prognostic factors were assessed according to the International Prognostic Index for diffuse large cell B lymphoma and T-cell lymphoma, the Mantle Cell Lymphoma International Prognostic Index and the Follicular Lymphoma International Index for mantle cell lymphoma and small cell lymphoma respectively. B-cell lymphomas were treated with polychemotherapy with or without rituximab, T-cell lymphomas were treated with polychemotherapy alone. Progression was assessed on the basis of response to treatment, toxicity and survival. Results: We included 40 patients, 30 males and 10 females with a sex ratio of 3. The mean age was 43.38 years +15.87. The mean time from symptom onset to diagnostic confirmation was 7.4 months. The total follow-up time of the cohort was 30.5 patient-years. B-cell lymphomas accounted for 57.5% of cases, T-cell lymphomas for 27.5% of cases. Twenty-five patients (67.6% of cases) were at an advanced stage at diagnosis. The initial prognosis was unfavourable in 29.7% of cases, all histological types combined. The overall survival at 30 months was 70%. Conclusion: Our patients were diagnosed with advanced disease stage. The overall survival at 30 months was short. Early diagnosis and better access to immunochemotherapy could improve these results.