Classification of non-Hodgkin lymphoma in the Middle Euphrates Region of Iraq according to the World Health Organization classification

Abstract

BACKGROUND: Non-Hodgkin lymphoma (NHL) patterns vary worldwide in relation to demographic and environmental factors. AIM: The objective of our study was to identify subtypes of NHL in the Middle Euphrates Region of Iraq according to the World Health Organization (WHO) modified classification. MATERIALS AND METHODS: A retrospective descriptive study was carried out at Al-Hussein Cancer Center in Karbala, Iraq, on 385 patients diagnosed with NHL between January 2012 and August 2020. Patient ages ranged between 1 and 96 years. They included 204 males and 181 females. All patients were diagnosed by tissue biopsy, confirmed by immunohistochemistry markers, and classified according to WHO classification. Any patient with inconclusive results was excluded from the study. RESULTS: Among total NHL patients, males were (53%) and females were (47%) with a male: female ratio of (1.12:1). B-cell lymphoma was diagnosed in (92.47%) and T cell lymphoma in (7.53%). Diffuse large B-cell Lymphoma (DLBCL) was the most frequent B-cell subtype (54.02%) followed by Burkitt's lymphoma (BL) (14.02%), while peripheral T-cell lymphoma was the most common T-cell subtype (2.08%). About (61.82%) of patients were nodal, and (38.18%) were extranodal. The intestine was the most frequent extranodal site (34.69%). CONCLUSION: Among our patients, there were high frequencies of DLBCL, extra nodal primaries and intestinal BL. Follicular lymphoma and small lymphocytic lymphoma were uncommon in our region. These results were similar to the Middle Eastern NHL patterns but differed from the western patterns.