Hodgkin Lymphoma in the West of Algeria: Panorama of Characteristics, Initial Work-up, Survival and Risk Factors Distribution
Tamim Alsuliman1, Amine Bekadja1*, Abdessamed Arabi1, Hadj Touhami2, Fatiha Mekkous-Touhami2, Zahia Zouaoui3,Asma Hadjeb3, Naima Mesli4, Nadia Houti4, Nemra Mehalhal5, Aissa Bachiri6 and Rachid Bouhass1
- *Corresponding Author:
- Amine Bekadja
Department of Hematology and cell therapy
EHU-Oran University Hospital Establishment
E-mail: [email protected]
Received Date: February 24, 2014; Accepted Date: March 17, 2014; Published Date: March 19, 2014
Citation: Alsuliman T, Bekadja A, Arabi A, Touhami H, Mekkous-Touhami F, et al. (2014) Hodgkin Lymphoma in the West of Algeria: Panorama of Characteristics, Initial Work-up, Survival and Risk Factors Distribution. J Blood Lymph 4:120. doi: 10.4172/2165-7831.1000120
Copyright: © 2014 Bekadja A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: The principal object of this study is to represent - in maximum accuracy- the real status of Hodgkin’s lymphoma in west of Algeria, we think also it serves as an adequate indicator for the epidemiological characteristics of HL patients and as an overview of these patients treatment and survival in Algeria.
Patients and methods: From December 2007 to the 1st of January 2013, 668 patients were included in this study, from the age of 15 to 88 years, and both genders. 8 hematology centers participated covering the west of Algeria. All diagnostic procedures and treatment policies were unified between the involved centers, the pilot center (Oran1) adapted a strict system for data collection, control and confirmation, WHO/REAL system was used for histological classification and ECOG system for the performance status. The therapeutic approach consisted of chemotherapy combined or not with radiotherapy according to clinical stage followed when appropriate with intensification protocol and autologous stem cell transplantation.
Results: Of our 668 patients: 53% were males, 47% females, global median age was 36 years [15-88], localized disease was presented in 22% of our study patients, while 78% presented advanced stages, rates of peripheral bulky, Mediastinal Bulky and Non-Bulky disease were: 8%, 45% and 47% respectively. 9% of patients had bone marrow involved by HL. 18% of patients had imaging of affected spleen, while 9% had features of affected liver. 74% of patients had one or more of B-symptoms, 68% of males and 74% of females were anemic, 28% of patients had leukocytosis 65% of all patients had nodular sclerosis subtype. Cumulative Overall Survival was estimated in 352 evaluable patients: 59% (at 60 months), 69% (at 48 months), while 79% of patients were alive after 5 years of follow-up. Cumulative OS for males was: 64% (at 48 months), and Cumulative OS of females: 75% (48 months) P-value>0.05 For patients aged more or less than 45 years, Cumulative OS were 43 and 49 months respectively for the means of OS. With P=0,016 of the 352 evaluable patients: 129 patients had reached CR and been qualified for DFS statistical analysis. Relapse rate was 16%, Cumulative Disease-Free Survival was 69% (at 48 months), no statistically significant difference had been detected between patients aged more or less than 45 years P value = 0.811.
Conclusion: Differences in survival rates between this study and publications maybe explained partially by the very high frequency of negative prognostic factors in our cohort like bulky and advanced disease, B-symptoms, and anemia positivity rates, lack of PET-CT and radiotherapy centers number may had also affected these results, even though we found ourselves very interested in deepening further more in diagnosis, treatment and follow – up modalities standardization and development in west of Algeria in order to raise the level of health services offered to HL patients to meet eventually developed countries survival rates.