OBJECTIVE: To re-evaluate clinico-pathologic categorisation of patients with
Hodgkin's lymphoma, treatments offered and their appropriateness, and outcome of
this disease at Kenyatta National Hospital in the 1990s.
DESIGN: Retrospective survey of Hodgkin's lymphoma patients aged 13 years and
above at the Kenyatta National Hospital.
SETTING: Kenyatta National Hospital, Nairobi, Kenya.
SUBJECTS: Patients aged 13 years and above, with diagnosis of Hodgkin's lymphoma.
RESULTS: There were 75 males and 36 females. One case had no clear gender
details. 14.2% of the cases were of lymphocyte predominant histologic subtype,
23.6% nodular sclerosis, 26.4% mixed cellularity and 17% Lymphocyte depletion
(Rye Modification of Lukes and Butler Classification). Disease stages IIIB, IVA
and IVB (Ann Arbor) were found in 24.5% of the cases. The majority of the
patients (60.3%) were treated with the COPP protocol and 17% with ABVD. Complete
remission was realised in 56% of the cases and most cases were lost to follow-up,
making it difficult to correlate survival with known prognostic parameters, apart
from early stage disease and attainment of complete remission which correlated
with prolonged durations of follow-up.
CONCLUSION: The patients had earlier stage diseases than in earlier studies
locally, the histologic classification is still wanting, and the COPP protocol
appeared still popular instead of being abandoned. Response rates were lower than
expected and losses to follow-up made it difficult to properly evaluate
prognostic parameters. Early disease stage and attainment of complete remission
appeared to correlate with longer follow-up duration.