Clinical study of malignant lymphomas in Duhok : a case series study during 2007-2013

Abstract EN

Background and Objectives Earlier studies have addressed the pathological classification of malignant lymphomas in Duhok, while no studies have addressed the clinical aspects and outcome of treatment.

Aim to identify clinical features, diagnostic procedures, standard treatment and outcome of malignant lymphomas in Duhok Material and Methods This is a case series study of 108 initially untreated patients with malignant lymphoma who were followed during the period 2007 to 2013.

Results The 108 enrolled patients included 61 patients with Non-Hodgkin’s Lymphoma (NHL) and 47 with Hodgkin’s Lymphoma (HL).The median age of patients with NHL was 52 (48.4±22.5) years while that of patients with HL was 29 (34.4±16.4) years.

The principal clinical presentation was cervical lymphadenopathy; 38% in NHL and 70% in HL.

Bsymptoms were present in 20% of NHL patients and 32% of HL patients.

The staging of patients with NHL showed that they were mostly in stages III and IV, while patients with HL were mostly in stage II.

Bone marrow involvement was found in 35% of patients with NHL and in 3% of patients with HL.

The standard treatment for NHL was protocol R-CHOP, given every 21 days; each patient received an average of 8 cycles.

For HL, the standard treatment was the ABVD protocol given in an average of 6 cycles.

Of all the patients with NHL, eight had relapse and were put on second line therapy (ICE protocol) while four died from infections.

Of the patients with HL, two had relapsed and one died from infection.

Conclusion The NHL in the studied patients was characterized by a severe course and multiorgan involvement, and stage III and IV were the main presenting stages at diagnosis.

The high rates of marrow involvement, extranodal involvement and advanced clinical stages in NHL as compared to HL, which are shared by previous studies worldwide, explain its less favourable outcomes as shown by the current study.