Signs, Symptoms and Complications of Non-Hodgkin's Lymphoma According to Grade and Stage in South Iran

  • Dehghani, Mehdi (Department of Hematology Oncology, Shiraz University of Medical Sciences, Hematology research center) ;
  • Haddadi, Sara (Department of Hematology Oncology, Shiraz University of Medical Sciences, Hematology research center) ;
  • Vojdani, Reza (Department of Hematology Oncology, Shiraz University of Medical Sciences, Hematology research center)
  • Published : 2015.04.29


Background: Non-Hodgkin's lymphoma (NHL) is a heterogeneous type of neoplasm of the lymphatic system. To have a more accurate and early diagnosis we need to know signs, symptoms and complications of lymphoma in early stages besides pathology and immunohistochemistry. Materials and Methods: This prospective study included 110 cases of NHL that were followed since February 2012 till November 2013. Biopsies were taken from all the patients besides bone marrow study. Signs and symptoms were categorized into "B" symptoms, general, lymphadenopathy and extranodal involvement and we compared the frequencies by stage and grade. Results: Of 110 cases, 88.9% had B-cell and 11.1% T-cell type with mean age $48.5{\pm}18.6$ years. "B" symptoms and lymphadenopathy were more common in men. Cervical lymphadenopathy was the most common sign (44.8%). and hematologic, bone marrow, bone and neurologic lesions were the most common complications. All complications were more common in males. "B" symptoms were seen mostly in stage III, general signs and symptoms in stage IV, and lymphadenopathy in stage II. Intermediate grade was also the most common in all signs and symptoms. In this study 12 (10.9%) patients had relapse, with neurologic and bone marrow as the most common sites of tumor recurrence. Conclusions: There is a meaningful relationship between male gender for NHL and anemia that can be due in part to higher incidence of bone marrow involvement and stage IV disease in male cases. We also found a strong relationship between low grade NHL and age. On the other hand extranodal involvement is more common in female groups.


  1. Albaseri AM, El-Siddig AA, Hussainy AS, et al (2014): Pattern of lymph node pathology in western Saudi Arabia. Asian Pac J Cancer Prev, 15, 4677-81
  2. Bhattacharya B, Choudhury K, Chattopadhyay B, Mitra D(2013). Primary extranodal non-Hodgkin's lymphoma:A retrospective analysis of its clinicopathological features and treatment outcomes in a tertiary cancer center of eastern India. Clin Cancer Invest J, 2, 218.
  3. Bolukbas F, Kutluturkan S(2014). Symptoms and symptom clusters in non hodgkin's lymphoma patients in Turkey. Asian Pac J Cancer Prev. 15, 7153-8.
  4. Conlan MG, Bast M, Armitage JO, Weisenburger DD(1990). Bone marrow involvement by non-Hodgkin's lymphoma: the clinical significance of morphologic discordance between the lymph node and bone marrow. Nebraska Lymphoma Study Group. J Clin Oncol, 8, 1163-72.
  5. d'Amore F, Christensen BE, Brincker H, et al (1991). Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Eur J Cancer Clin Oncol, 27, 1201-8.
  6. Hashemi-Bahremani M, Parwaresch MR, Tabrizchi H, et al (2007). Lymphomas in Iran. Arch Iranian Medicine, 10, 343-8.
  7. Hingorjo MR, Syed S (2008). Presentation, staging and diagnosis of lymphoma: a clinical perspective. J Ayub Medical College, 20, 100-3.
  8. Huff CA , Matsui W, Smith BD, Jones RJ(2006).The paradox of response and survival in cancer therapeutics. Blood, 15, 431-4.
  9. Jemal A, Bray F, Center MM,et al(2011). Global cancer statistics. CA: A Cancer J Clin, 61, 69-90.
  10. Johnston PB, Yuan R, Cavalli F, Witzig TE( 2010).Targeted therapy in lymphoma. J Hematol Oncol, 23, 3, 45.
  11. Moullet I, Salles G, Ketterer N, et al (1998). Frequency and significance of anemia in non-Hodgkin's lymphoma patients. Ann Oncol, 9, 1109-15.
  12. Muller AM, Ihorst G, Mertelsmann R, Engelhardt M (2005). Epidemiology of non-Hodgkin's lymphoma (NHL): trends, geographic distribution, and etiology. Ann Hematology, 84, 1-12.
  13. Ng AK, LaCasce A, Travis LB(2011). Long-term complications of lymphoma and its treatment. J Clin Oncol, 29, 1885-92.
  14. Roman E, Smith AG(2011). Epidemiology of lymphomas. Histopathology, 58, 4-14.
  15. Sader-Ghorra C, Rassy M, Naderi S, et al(2014). Type distribution of lymphomas in Lebanon: five-Year single instituton experience. Asian Pac J Cancer Prev, 15, 5825-8.
  16. Schwenkglenks M, Bendall KL, Pfeil AM,et al(2013). External validation of a risk model of febrile neutropenia occurrence in patients with non-Hodgkin lymphoma. Leukemia & lymphoma, 54, 2426-32.
  17. Zelenetz AD, Abramson JS, Advani RH, et al (2011). Non-Hodgkin's lymphomas. J Natl Compr Canc Netw, 9, 484-560.

Cited by

  1. Low-intensity exercise therapy with high frequency improves physical function and mental and physical symptoms in patients with haematological malignancies undergoing chemotherapy pp.09615423, 2018,
  2. Characteristics of muscle function and the effect of cachexia in patients with haematological malignancy pp.09615423, 2018,