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Treating Adults with Hodgkin Lymphoma in the Developing World: a Hospital-Based Cohort Study from Armenia

  • Avagyan, Armen (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Danielyan, Samvel (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Voskanyan, Astghik (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Sargsyan, Lilit (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Hakobyan, Lusine (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Zohrabyan, Davit (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Safaryan, Liana (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Harutyunyan, Lilit (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Bardakchyan, Samvel (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Iskanyan, Samvel (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Arakelyan, Samvel (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University) ;
  • Tamamyan, Gevorg (Department of Oncology, Yerevan State Medical University and Clinic of Chemotherapy, Muratsan University Hospital, Yerevan State Medical University)
  • Published : 2016.02.05

Abstract

Background: With advances in diagnostics and treatment approaches, patients with Hodgkin's lymphoma (HL) in developed countries can nowadays expect to have excellent outcomes. However, information about the characteristics and outcomes in the developing world is very scarce, and this is important given the fact that there are several reports about differences of disease characteristics depending on geographic location and the development level of the country. Materials and Methods: In this retrospective study we assessed the features of 36 adult (${\geq}18$ years old) patients with HL and their diagnosis and treatment and outcomes in the Clinic of Chemotherapy of Muratsan University Hospital of Yerevan State Medical University, Armenia, between 2008-2014. Results: All patients had classic HL and among them 19 (53%) had nodular sclerosis subtype, 8 (22%) mixed cellularity and 9 (25%) lymphocyte-rich. 16 (44.5%) patients were at stage II, 13 (36%) stage III and 7 (19.5%) stage IV. Median follow-up time was 24.5 months (range 1-71 months) and during the whole follow-up period only two relapses (early) were documented and there were no deaths. Twenty-three (64%) patients received a BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) regimen, and 13 (36%) ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) regimen. A total of 25 (69.5%) patients received radiation in addition to chemotherapy. Conclusions: Although the number of patients involved in the study is small and the median follow-up time was just two years, this retrospective study shows that treatment of HL can be successfully organized in a resource-limited setting.

Keywords

Hodgkin's lymphoma;developing country;Armenia;ABVD;BEACOPP

References

  1. Andjelic B, Antic D, Jakovic L, et al (2014). A single institution experience on 314 newly diagnosed advanced hodgkin lymphoma patients: the role of ABVD in daily practice. Eur J Haematol, 93, 392-99. https://doi.org/10.1111/ejh.12364
  2. Baharvand M, Mortazavi H (2014). Characteristics of Hodgkin lymphoma in a defined group of iranian pediatric patients. Asian Pac J of Cancer Prev, 15, 5167-69. https://doi.org/10.7314/APJCP.2014.15.13.5167
  3. Bosetti C, Levi F, Ferlay J, et al (2009). The recent decline in mortality from hodgkin lymphomas in central and eastern europe. Ann Oncol, 20, 767-74. https://doi.org/10.1093/annonc/mdn673
  4. Carbone P, Kaplan H, Musshoff K, et al (1971). Report of the committee on hodgkin's disease staging classification. Cancer Res, 31, 1860-61.
  5. DeSantis C, Lin C, Mariotto A, et al (2014). Cancer Treatment and Survivorship Statistics. CA Cancer J Clin, 64, 252-71. https://doi.org/10.3322/caac.21235
  6. Dinand V, Arya L (2006). Epidemiology of childhood hodgkins disease: is it different in developing countries? Indian Pediatr, 43, 141-47.
  7. Fadhil M, Al-Nueimy W, Lazim A (2014). Hodgkin's lymphoma. an immunohistochemical profile in Northern Iraq. Saudi Med J, 35, 448-53.
  8. Foss Abrahamsen A, Egeland T, Hansen S, et al (1997). Hodgkin's disease in a national and hospital population: trends over 20 years. Eur J Cancer, 33, 2380-83. https://doi.org/10.1016/S0959-8049(97)00342-0
  9. Geller S, Taylor C (2013). Thomas hodgkin: the 'man' and 'his disease': humani nihil a se alienum putabit (nothing human was foreign to him). Virchows Arch, 463, 353-65. https://doi.org/10.1007/s00428-013-1442-0
  10. Gender Statistics. Highlights from (2012). World Development Report (2012). [Online].
  11. Georgii A, Fischer R, Hubner K, et al (1993). Classification of hodgkin's disease biopsies by a panel of four histopathologists. report of 1,140 patients from the German National Trial. Leuk Lymphoma, 9, 365-70. https://doi.org/10.3109/10428199309148535
  12. Hakobyan T, Nazaretyan M, Makarova T, et al (2006). Armenia: health system review. Health Syst Transit, 8, 1-202.
  13. Harris N (1999). Hodgkin's lymphomas: classification, diagnosis, and grading. Semin Hematol, 36, 220-32.
  14. Hessissen L, Khtar R, Madani A, et al (2013). Improving the prognosis of pediatric hodgkin lymphoma in developing countries: a moroccan society of pediatric hematology and oncology study. Pediatr Blood Cancer, 60, 1464-69 https://doi.org/10.1002/pbc.24534
  15. Lee M, Tan T, Feng A (2005). Clinico-pathological study of hodgkin's lymphoma in a cancer center in Taiwan. Clin Lab Haematol, 27, 379-83. https://doi.org/10.1111/j.1365-2257.2005.00736.x
  16. Lister T, Crowther D, Sutcliffe S, et al (1989). Report of a committee convened to discuss the evaluation and staging of patients with hodgkin's disease: cotswolds meeting. J Clin Oncol, 7, 1630-66. https://doi.org/10.1200/JCO.1989.7.11.1630
  17. Macfarlane G, Evstifeeva T, Boyle P, et al (1995). International patterns in the occurrence of hodgkin's disease in children and young adult males. Int J Cancer, 61, 165-69. https://doi.org/10.1002/ijc.2910610204
  18. National Statistical Service of Republic of Armenia (2015). [Online].
  19. NCCN Clinical Practice Guidelines in Oncology. Hodgkin Disease/Lymphoma (2008). Vol 2. [Online].
  20. Olu-Eddo A, Omoti C (2011). Hodgkin lymphoma: clinicopathologic features in benin city, nigeria and update on its biology and classification. Niger J Clin Pract, 14, 440-44. https://doi.org/10.4103/1119-3077.91752
  21. Ramadas K, Sankaranarayanan R, Nair M, et al (1994). Adult Hodgkin's disease in Kerala. Cancer, 73, 2213-17. https://doi.org/10.1002/1097-0142(19940415)73:8<2213::AID-CNCR2820730829>3.0.CO;2-R
  22. Richardson E (2013). Armenia: health system review. Health Syst Transit, 15, 1-99.
  23. Riyat M (1992). Hodgkin's disease in Kenya. Cancer, 69, 1047-51. https://doi.org/10.1002/1097-0142(19920215)69:4<1047::AID-CNCR2820690436>3.0.CO;2-Z
  24. Sant M, Allemani C, Tereanu C, et al (2010). Incidence of hematologic malignancies in europe by morphologic subtype: results of the haemacare project. Blood, 116, 3724-34. https://doi.org/10.1182/blood-2010-05-282632
  25. SEER 18 Stat Fact Sheets (2008-2012) - Hodgkin lymphoma. [Online].
  26. Sherief L, Elsafy U, Abdelkhalek E, et al (2015). Hodgkin lymphoma in childhood: clinicopathological features and therapy outcome at 2 centers from a developing country. Med, 94, 670 https://doi.org/10.1097/MD.0000000000000670
  27. Shimabukuro-Vornhagen A, Haverkamp H, Engert A (2005). Lymphocyte-rich classical Hodgkin's lymphoma: clinical presentation and treatment outcome in 100 patients treated within german hodgkin's study group trials. J Clin Oncol, 23, 5739-45. https://doi.org/10.1200/JCO.2005.17.970
  28. Siddiqui N, Ayub B, Badar F, et al (2006). Hodgkin's lymphoma in Pakistan: a clinico-epidemiological study of 658 cases at a cancer center in Lahore. Asian Pac J Cancer Prev, 7, 651-55.
  29. Sughayer M, Haddad H, Al-Yousef R, et al (2014). Epstein-barr virus and hodgkin lymphoma in Jordan. Hematol Oncol Stem Cell Ther, 7, 85-89. https://doi.org/10.1016/j.hemonc.2013.12.002
  30. Swerdlow S, Campo E, Harris N, et al (2008). WHO classification of tumours of haematopoietic and lymphoid tissues. IARC WHO Classification of Tumours, 2, 1-439.
  31. Torre L, Bray F, Siegel R, et al (2015). Global Cancer Statistics, 2012. CA Cancer J Clin, 65, 87-108. https://doi.org/10.3322/caac.21262
  32. World Health Organization Global Health Expenditure Database 2010-2014 (2015). [Online].
  33. Yaqo R , Hughson M, Sulayvani F, et al (2011). Malignant lymphoma in northern Iraq: a retrospective analysis of 270 cases according to the world health organization classification. Indian J Cancer, 48, 446-51 https://doi.org/10.4103/0019-509X.92276