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