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بسم الله الرحمن الرحيم
Adult Hodgkin’s Lymphoma in the Eastern Part of Libya
Dr. M.Mangoush, Dr. M.Mangoush, R. NafoR. Nafo, S.Kardah, M.Letaiwish, S.Kardah, , S.Kardah, M.Letaiwish, S.Kardah,
F.Bodabous, S.EbkhatraF.Bodabous, S.Ebkhatra.
Faculty of medicine, Gar-Younis University , Benghazi - Libya
Summary:
Between 1984-2001,we reviewed retrospectively all medical records of 271 patients from eastern part of Libya. ( 153 men and 118 women, age ranged from 14-80 years)
Among total 33% patients presented with A symptoms and 66% presented with B symptoms .
Histological 47% have nodular sclerosis,34% have mixed cellularity, 16% have lymphocytic rich and 3% have lumphocytic depleted .
Clinically: stages III/ IV account 70% of total and remainder were presented with stages I /II.
Among total (47%) of patients achieved complete remission following combined chemotherapy, (21%) with partial remission and (32%) of patients did not follow up.
5 years follow up survival obtained in 116 patients were 84 patients remained in remission after 5 years (72.4 %) and 32 patients with no follow up (27.6 %).
Introduction
Hodgkin’s disease (H.D) is a potentially
curable malignant type of lymphoma. First described by Thomas Hodgkin in
1832. Has a distinct histopathology, biological
behavior and clinical characteristics.
Aim of the Current Study
1. To assess the management.
2. To find out the means to improve early detection and treatment for better outcome.
We reviewed retrospectively all medical records of patients who were treated for HD in Hematology department from 1984 through 2001.
Our department includes medical services in both Jamahiriya and Hawari hospitals. (The only referral department for hematological cases in the eastern part of Libya).
The review included:
Material and methods
Demographic information: age, sex, address, occupation.
Relevant clinical parameters written by resident physician in the admitting history and daily follow up notes.
Laboratory values. Type and dose of the drugs. Follow up records.
Results
302 patients were treated for HD in our department.
271 (89.7%) Libyan patients from the eastern part .
21 (7%) patients from other areas
10 (3.3%) Non-Libyan patients.
Libyan patients from eastern part only were included in the study.
302271
10 21
050
100150200250300350
Total Libyan Non-Libyan
Otherareas
Years Distribution:
8
12
17
1210
8
6
16
20
13
2120
21
1920
11
16
23
0
5
10
15
20
25
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1
Mean number of patients per year = 15.1667 ± 5.283
SexNumberAge Range
Mean � Age
Male153 (56.5%)14 - 8032.6 ± 16.48
Female118 (43.5%) 14 - 74 26.9 ± 13.11
Total271 (100%)14 – 80 Years
30.7 ± 15.46 Years
Male / Female Distribution:
0246810121416
NO. O
F CA
SES
Male / Female Distribution = 1.3 / 1
► Male ► Female
Well Staged Patients ( No : 218 = 80.4% ):
3 (1.4%)
49 (22.5%)
82 (36.6%) 84 (38.5%)
0
10
20
30
40
50
60
70
80
90
I II III IV
34% had “A” Symptoms66% had “B” Symptoms
Num
ber
of p
atie
nts
Histological Subtypes:
16%
47%
34%
3%
0%
10%
20%
30%
40%
50%
L.P N.S M.C L.D
Outcome:
271
23 (8.5%)
0
50
100
150
200
250
300
Total Treated No-treated
Num
ber
248) 91.5%(
Modalities of Treatment: Initial therapy
23 (9.3%)
187 ( 75.4%)
38 (15.3%)
0
50
100
150
200
Radiotherapy Chemotherapy Both
No
of P
atie
nts
Modalities of Chemotherapy:
32 (17.1%)
48 (25.7%)43 (23%)
64 (34.2%)
0
10
20
30
40
50
60
70
MOPP ABVD Both Others
Nu
mb
er
of p
atie
nts
Remission:
116 (46.8%)
52 (21%)
80 (32.6%)
0
20
40
60
80
100
120
IductionRemission
NoRemission
No-followup
Nu
mb
er
of p
atie
nts
Induction Remission OR Relapse:
0
2
4
6
8
10
12
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1
Relapse
Remission 46.8%
Nu
mb
er
of p
atie
nts 21%
Nu
mb
er
of p
atie
nts
Stage of Patients Induction Remission:
19
27
40
30
0
10
20
30
40
I II III IV Stage
16.3%
25.9%23.3%
34.5%
INDUCTION REMISSION
COMPLETE COMPLETE 47%47%
PARTIAL PARTIAL 2121%%
5 Years Survival Rate
five years follow up was obtained in 116 patients.
84 (72.4%) Remained in Remission. 22 (27.6%) were not followed up.
:Conclusion
H.D is a curable disease provided an early diagnosis, proper management and regular follow up.
Better remission rate can be obtained by upgrading of the medical services.
Thank You