Frequencies of non-Hodgkin's lymphoma subtypes in Kuwait: comparisons between different ethnic groups.

There is a wide variation in the prevalence of various subtypes of non-Hodgkin's lymphoma worldwide. The aim of this study was to determine the relative frequency of different subtypes of non-Hodgkin's lymphoma in Kuwait based on the Revised European-American Lymphoma (REAL) classification. From 1998 to 2006, 738 subjects were included that were registered with non-Hodgkin's lymphoma in the population-based cancer registry at the Kuwait Cancer Control Center. Expert pathologists reviewed histological slides from all subjects. We performed detailed immunohistochemical studies and classified subjects based on the REAL classification. The prevalence of different types of non-Hodgkin's lymphoma was determined based on age, sex, site of disease, and ethnicity. Ethnicity groups comprised Kuwaiti Arabs, non Kuwaiti Arabs, Asians, and others. The prevalence of B- and T-cell lymphomas was 81.8% and 14.2%, respectively. The most common age group was 41-60 years old. The three most common subtypes in Kuwaiti Arabs were diffuse large B-cell lymphoma (46.5%), follicular lymphoma (15.5%), and mycosis fungoides (9.3%). In non-Kuwaiti Arabs, the most common subtypes were diffuse large B-cell lymphoma (48%), B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (15.8%), and follicular lymphoma (12.7%). Overall, non-Kuwaiti Arabs exhibited the highest prevalence (59%), and 54% of all cases had extranodal presentation. Compared to the Western world, Kuwait had a lower prevalence of follicular lymphoma, a higher prevalence of diffuse large B-cell lymphoma and extranodal presentation, and a high frequency of mycosis fungoides. Compared to other parts of Asia, Kuwait had a lower frequency of peripheral T-cell lymphomas.

Extranodal lymphoma: a comparative study.

BACKGROUND: The incidence of extranodal non-Hodgkin's lymphoma (NHL) is increasing worldwide. The epidemiology of NHL in the Middle East is largely unknown. PATIENTS AND METHODS: We evaluated all cases of NHL diagnosed at our institutions between 1998 and 2003 according to the site of presentation and their classification into primary nodal and primary extranodal NHL using strict criteria. Extranodal cases and early stage primary nodal cases were compared in terms of clinical characteristics and treatment outcomes. RESULTS AND DISCUSSION: There were 422 NHL cases diagnosed between January 1998 and December 2003, among which 97 cases (23%) were primary nodal, 132 (31%) were early nodal, and 193 (46%) were disseminated primary nodal. In general, there was a male preponderance of primary nodal cases (63% versus 44%; p=0.007). There was a higher prevalence of primary nodal cases in Arabs than in Asians: Kuwaiti Arabs, 50%; other Arabs, 46%; and Asians, 11%. There was a different distribution of histologic subtypes between primary nodal and extranodal NHL (p=0.001). The most common histologic subtype among extranodal cases was diffuse large B cell lymphoma, which accounted for 71% (69) of cases. The most common anatomic site involved was the gastrointestinal tract, which accounted for 45% of all cases. The difference in event-free survival between nodal and extranodal low-grade NHL was not statistically significant (p=0.17). Primary nodal high-grade lymphomas show an overall survival than the primary extranodal disease (p=0.003). CONCLUSION: We conclude that extranodal NHL is common among patients of Arabic descent. Diffuse large B cell lymphoma is the most common histologic subtype and often involves the gastrointestinal tract. Patients with aggressive primary extranodal NHL have lower overall survival than patients with early primary nodal disease.

Factors influencing engraftment in autologous peripheral stem cell transplantation. The experience of a local Kuwaiti transplantation center.

OBJECTIVE: To assess factors affecting engraftment among patients with lymphoproliferative disorders treated with high dose-chemotherapy and autologous peripheral blood stem cell transplantation. METHODS: Fifty-four patients with lymphoproliferative disorders were treated from March 2000 to April 2006, at the Hamid Al-Essa Multiorgan Transplant Center, Kuwait. There were 37 males and 17 females, with a median age of 43 years (range 12-60). The cohort included 13 Hodgkin's lymphoma, 31 non-Hodgkin's lymphoma, and 10 multiple myeloma cases. RESULTS: The median number of infused CD34+ cells was 1.7x10(6) per kg (0.38-15). The medians for absolute neutrophil count (ANC) and platelet (PLT) engraftment were 12 days (10-15) and 11 days (6-33). The CD34+ cell dose and timing of granulocyte-colony stimulating growth factor administration had no significant influence on ANC engraftment (p=0.3 and p=0.05). CONCLUSION: The results imply that the CD34+ cell dose is the most important predictor of hematopoietic engraftment, namely PLT engraftment. The other factors studied had no clear influence on engraftment kinetics in this cohort.

Primary gastrointestinal non-Hodgkin's lymphoma: treatment outcome.

Primary gastrointestinal lymphoma is the most common extranodal presentation of non-Hodgkin's lymphoma. In this retrospective study, all cases of primary gastrointestinal lymphoma registered at Kuwait Cancer Control Center between January 1992 and December 2001 were reviewed. Patients were diagnosed through an endoscopic biopsy or exploratory laparotomy. Staging procedures included computed axial tomography scan, bone marrow biopsy, barium and follow-through study, as well as routine chemistry (including lactate dehydrogenase) and hemography. There were 46 patients (30 men and 16 women); ages ranged from 16 to 82 years (median age, 43.6 years). The most common site of involvement was the stomach (70%), and the most common histology was large B cell. At least 50% of cases underwent primary radical surgery, and the majority of patients received subsequent chemotherapy and/or local radiation therapy. Chemotherapy consisted of the CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) regimen for large B-cell histology and CVP (cyclophosphamide/vincristine/prednisone) or oral alkylating agents for low-grade histology. Of this cohort, only 12 cases (26%) have had local or distant relapse. Disease-free survival rates for low-grade and high-grade non-Hodgkin's lymphoma were 64% and 81%, respectively. Primary gastrointestinal lymphoma is a potentially curable malignancy.