ABCL-299: Updated Purview of Lymphomas in India: A Tertiary Care Centre Review

Abstract

Context: Lymphomas are a group of neoplasms of immune cells with varied demographic, histopathological, immunophenotypic and molecular profiles. Geography affects the epidemiology, patient profile, and treatment response. Aims and Objectives: We analysed the epidemiological characteristics of lymphomas in our centre over a period of five years. Design: This was a retrospective study wherein all lymphoma-related biopsies from 2015 to 2019 were reviewed from the database of the Department of Pathology, AIIMS, New Delhi. The cases were classified according to WHO classification 2017 with detailed histomorphological and immunophenotypic evaluation. Results: Of the total 4115 lymphoma cases diagnosed, non-Hodgkin lymphoma (NHL) dominated (69.65%; n=2866), while Hodgkin lymphomas (HL) comprised 30.35% (n=1249). The primary site of involvement was nodal in 65.13% cases, and 34.87% were extranodal. There was an overall male predominance. Among the NHLs, B-cell type comprised 84.08% and 15.38% were T- and NK cell lymphomas. Immature cell neoplasms were 7.11% (n=204) of the NHLs. Among the mature B cell lymphomas, diffuse large B cell lymphoma predominated (42.53%), followed by follicular lymphoma (10.81%) and small lymphocytic lymphoma (6.10%). Among the T-cell type, PTCL NOS (2.65%) was the most common subtype, followed by ALK-positive anaplastic large cell lymphoma (ALCL-ALK+) (2.44%). Classical type was the predominant type (97.91%), co-dominated by nodular sclerosis (28.1%) and mixed cellularity (32.18%) among HL, and 2.08% were the nodular lymphocyte predominant type. Conclusions: As indicated by the study, Indian populations differ in the prevalence, presentation, and subtyping among various lymphomas. A younger median age of presentation with higher male preponderance was seen. Higher prevalence of immature cell neoplasm, Hodgkin lymphoma, DLBCL, and ALK+ALCL were noted as compared to the Western population. In order to help scientific research, patient management and planning of health services, generation of epidemiological data is essential.