Abstract
Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and descriptive study carried out in the pediatric oncology unit of the Gabriel Toure Teaching Hospital Bamako over 10 years from 1st January 2005 to 31th December 2015. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%); the male sex was predominant with a sex-ratio of 1.8; digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%); the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs; the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate. Abdominal localization was the most common (43.1%) followed by maxillofacial localization (33.9%). Almost all were Burkitt type cytology (92.7%), the majority (73.4%) were in Murphy stage III. Almost all (96%) had received chemotherapy and the modified LMB 01 protocol was widely used (62.4%). The majority of patients (85%) were chemosensitive at day 7 or after the third cyclophosphamide injection but at the end of induction only 31% were in complete remission. Gastrointestinal toxicity was the most common (37.13%) followed by hematologic toxicity 35.09 %; 9.12 % of patients were lost of follow-up and 22.26% died. Tumor progression was the most common cause of death (60.66%) followed by infection (21.31%). Conclusion: In light of these findings, the late diagnosis and the poor management of NHL, as well as the limited ability to primarily treat metabolic complications, explain the high case-fatality rate, hence the important role of early diagnosis and treatment multidisciplinary.
Highlights
The global cancer burden is set to increase to 21.6 million cases by 2030 mainly in Latin America, Asia and Africa [1].Over 60% of the total number of cancer cases in the world occur in Africa, central Asia and South America
We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%); the male sex was predominant with a sex-ratio of 1.8; digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%); the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs; the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate
Even though cure is possible in most childhood cancer cases, the death rate in the world remains high given that 80% of children affected by cancer live in developing countries where no effective treatment is available
Summary
Over 60% of the total number of cancer cases in the world occur in Africa, central Asia and South America. These regions register about 70% of cancer deaths across the world, a situation compounded by the absence of early screening and access to treatment [2]. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%); the male sex was predominant with a sex-ratio of 1.8; digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%); the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs; the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate.
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