Diffuse Large B-cell Lymphoma in Adults at Chris Hani Baragwanath Academic Hospital

Abstract

Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common subtype of Non-Hodgkin lymphoma (NHL). DLBCL is a heterogenous disease and is the most common subtype of NHL occurring in Human Immunodeficiency Virus (HIV) seropositive individuals. Aim: The aim of the study was to review the clinical profile as well as the outcome of adult patients presenting with DLBCL, to a tertiary public sector hospital (Chris Hani Baragwanath Academic Hospital – CHBAH) in Soweto, Johannesburg, South Africa. Patients and Methods: The study entailed a retrospective review of 139 evaluable patients with DLBCL, over a 5 year period. Results: Of the 139 patients reviewed, there were 73 females (53%) and 66 males (47%), with a female: male ratio of 1.1:1. The median age of the patients was 41 years (14-85). Common presenting features included advanced stage disease (83%), constitutional or ‘B’ symptoms (74%), extra-nodal disease (73%) and lymphadenopathy (64%). 81% of the patients were HIV seropositive. The median overall survival was 24 months. Conclusion: DLBCL accounted for 35% of all the patients with NHL during the study period. HIV seropositivity, together with other factors such as significant delays in referral of the patients, late presentations with advanced stage disease, and comorbidities such as Tuberculosis, impacted negatively on the prognosis and the outcome of the patients with DLBCL. Despite the use of Combination Antiretroviral Therapy (cART), appropriate supportive care and specific modalities of treatment, DLBCL continues to pose a challenge in our clinical setting.