Non Hodgkin Lymphomas (NHL) in the Pediatric Oncology Unit of the Gabriel Touré Teaching Hospital, Bamako Mali
2019
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.
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