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Incidence and treatment outcome of childhood lymphomas in a tertiary care hospital of a developed country: a study in combined military hospital Bangladesh


Hematology & Transfusion International Journal
Kamrun Nahar,1 Ahmed Rashidul Hasan,2 Shormin Ara Ferdousi,3 Md Azizul Islam,Afiqul Islam,5 Chowdhury Yakub Jamal6

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Abstract

Background: Over the years incidence of childhood cancer has been increasing. Being the third most common childhood malignancy, Lymphoma also achieved improved survival and reduced mortality along with other cancer in children & adolescents. Objective: The objective of the study was to analyze the incidence and overall outcome of childhood lymphoma patients aged 0-12 years who attended Combined Military Hospital (CMH), Dhaka, a tertiary level hospital in Bangladesh.

Methodology: It was a retrospective cross-sectional study. All the children up to 12 years with a confirmed diagnosis of Lymphoma who received treatment from the Paediatric Oncology Unit of the Department of Pediatrics CMH, Dhaka were taken for analysis. Their data has been collected from hospital-based cancer registry records from 2016 to 2021. Their present status has been collected by phone call. Data has been collected and put on datasheet of MS-Exel 2019 and were analyzed using SPSS –VR 25, MS-Exel 2019. Results: Over the study period, Childhood lymphomas were found one of the commonest cancer, with an incidence of 10%. Of them Hodgkin Lymphoma (HL, 41%), and NonHodgkin Lymphoma (NHL, 59%). For both, the most common age group was ‘5 to 9 years age’, females were predominance for HL & males were predominance in NHL. Histopathological analysis revealed the mixed cellularity variety of classical HL was the commonest; 71% of all HL. In case of NHL, 60% had Burkitt Lymphoma [BL] & 40% had Lymphoblastic Lymphoma [LL]. Immunohistochemistry of tumor masses revealed BL patients had B-Cell and all LL patients had T-cell. About 100% of patients agreed to start treatment and achieved remission but later on, 23.5% of them experienced a relapse. Overall survival was 76.5%. In case of HL 100% of patients survived, and 14% of them had relapsed. In case of NHL, 60% of patients survived [67% of BL & 50% of LL] and relapse was found in 30% of cases. Overall mortality rate was 23.5%, and all belonging to NHL represent 40% of all NHL patients. Conclusion: With current therapeutic & supportive regimens childhood lymphoma patients have excellent improvement. Even being a developed country, 100% of patients achieved remission and only 23.5% had relapsed. Overall survival was 76.5%, in case of HL 100%, and NHL 60%. Mortality rate was only 23.5%, all belonging to NHL.

Keywords

childhood lymphoma, NHL, HL, overall survival, relapse

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