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LETTER TO THE EDITOR
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 162-170

Profile of non-Hodgkin lymphoma: An Indian perspective


1 Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication13-Jul-2018

Correspondence Address:
Dr. Ajay Gogia
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sajc.sajc_60_18

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How to cite this article:
Gogia A, Das CK, Kumar L, Sharma A, Sharma M C, Mallick S. Profile of non-Hodgkin lymphoma: An Indian perspective. South Asian J Cancer 2018;7:162-70

How to cite this URL:
Gogia A, Das CK, Kumar L, Sharma A, Sharma M C, Mallick S. Profile of non-Hodgkin lymphoma: An Indian perspective. South Asian J Cancer [serial online] 2018 [cited 2018 Oct 18];7:162-70. Available from: http://journal.sajc.org/text.asp?2018/7/3/162/236583

Dear Editor,

Non-Hodgkin lymphoma (NHL) subtype, pattern of presentation as well as patient population, varies with geographical regions. The World Health Organization (WHO) 2016 lymphoma classification clarifies the diagnosis and management of NHL in relation to the stages of lymphomagenesis. It refines the diagnostic criteria to incorporate the expanding genetic/molecular landscape of NHL.[1] In view of comparative data regarding the distribution of NHL subtypes in India is scarce in the literature, we did this retrospective analysis of newly diagnosed patients with NHL treated in a tertiary care center. A total of 390 cases of adult (>18 years) NHL over a period of 27 months (May 1, 2013 and July 31, 2015) were registered in the Department of Medical Oncology at our institute (AIIMS, New Delhi). The individual NHL cases were retrospectively reviewed according to the WHO lymphoma classification 2016 revision, immunophenotypic expression and morphology. B-cell lymphomas formed 347 (89%) whereas T-cell lymphomas formed 43 (11%) of the NHLs. Diffuse large B-cell lymphoma (DLBCL) was the most common subtype which was present in 267 (68.5%) cases. Follicular lymphoma (FL), mantle cell lymphoma (MCL), marginal zone B-cell lymphoma, small lymphocytic lymphoma, and Burkitt's lymphoma amounted to 35 (9%), 20 (5%), 9 (2.3%), 5 (1.3%), and 5 (1.3%) of all NHLs cases, respectively. Among the T-cell lymphomas, peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) was the most common subtype 15 (3.85%), followed by anaplastic large-cell lymphomas, T-cell lymphoblastic lymphoma, NK/T-cell lymphoma, and angioimmunoblastic T-cell lymphoma which accounted for 9 (2.3%), 7 (1.8%), 5 (1.3%), and 2 (0.75%) of all NHL cases, respectively. Details of all NHL are given in [Table 1].
Table 1: Non-Hodgkin lymphoma subtypes in adults

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The present study of North Indian population shows key differences in the presentation as compared to the developing country and other parts of India. Details of epidemiological studies are summarized in [Table 2].
Table 2: Subtype distribution of lymphoma across India and the west (USA)

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Classifying NHL according to B- and T-cell type has therapeutic and prognostic significance. Epidemiology of the Indian subcontinent is marked different from that of the Western literature in view of marked preponderance of high-grade lymphoma especially DLBCL. In this study, 68.5% patients were DLBCL, which is significantly higher as compared to previous reported study from India and the West.[2],[3],[4],[5],[6] FL and MCL were the second and third most common subtype of B-NHL, and PTCL-NOS is the most common T-cell lymphoma in adult. The younger average age (median 50 years) of our patients is consistent with the pattern seen in most other malignancies in India, due to the effect of a younger population pyramid in our country.[7],[8] The present study of North Indian population shows key differences in the NHL subtypes as compared to the developed world and other parts of India.

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Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization (WHO) classification of lymphoid neoplasms. Blood 2016;6:643-569.  Back to cited text no. 1
    
2.
Nimmagadda RB, Digumarti R, Nair R, Bhurani D, Raina V, Aggarwal S, et al. Histopathological pattern of lymphomas and clinical presentation and outcomes of diffuse large B cell lymphoma: A multicenter registry based study from India. Indian J Med Paediatr Oncol 2013;34:299-304.  Back to cited text no. 2
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3.
Arora N, Manipadam MT, Nair S. Frequency and distribution of lymphoma types in a tertiary care hospital in South India: Analysis of 5115 cases using the World Health Organization 2008 classification and comparison with world literature. Leuk Lymphoma 2013;54:1004-11.  Back to cited text no. 3
    
4.
Naresh KN, Srinivas V, Soman CS. Distribution of various subtypes of non-Hodgkin's lymphoma in India: A study of 2773 lymphomas using R.E.A.L. and WHO classifications. Ann Oncol 2000;11 Suppl 1:63-7.  Back to cited text no. 4
    
5.
Sahni CS, Desai SB. Distribution and clinicopathologic characteristics of non-Hodgkin's lymphoma in India: A study of 935 cases using WHO classification of lymphoid neoplasms (2000). Leuk Lymphoma 2007;48:122-33.  Back to cited text no. 5
    
6.
Nair R, Arora N, Mallath MK. Epidemiology of Non-Hodgkin's lymphoma in India. Oncology 2016;91 Suppl 1:18-25.  Back to cited text no. 6
    
7.
Gogia A, Raina V, Kumar L, Sharma A, Sharma MC, Mallick SR, et al. Follicular lymphoma: An institutional analysis Asian Pac J Cancer Prev 2017;18:681-5.  Back to cited text no. 7
    
8.
Das CH, Gogia A, Kumar L, Sharma A, Sharma MC, Mallick SR, et al. Mantle cell lymphoma: A North Indian tertiary care centre experience Asian Pac J Cancer Prev 2016;17:4583-6.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2]



 

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