TY - BOOK AU - Maxwell P Shoo AU - Erius Tebuka AU - Anthony Kapesa TI - Treatment modalities and mortality of patients with lymphoma at Bugando Medical Centre, Mwanza, Tanzania PY - 0000///©28.072021/// CY - Mwanza, Tanzania PB - Catholic University of Health and Allied Sciences [CUHAS – Bugando] KW - N2 - 1.0 INTRODUCTION 1.1 Background Lymphomas are the solid tumors of the immune system mainly the lymph nodes, spleen, thymus gland and the bone marrow[1]. Lymphomas are classified into two major classes; the Hodgkin and Non Hodgkin depending on the presence or absence of reed stern beg cells respectively. Hodgkin lymphoma is an uncommon malignancy involving lymph nodes and the lymphatic system. It accounts for 10% of all lymphoma cases. Most patients are diagnosed between the age of 15 and 30 years followed by another peak in adults aged 55 years or older. The WHO classification divides the Hodgkin lymphoma into classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. The classical Hodgkin lymphoma is characterized by presence of reed-stern-berg cells in an inflammatory background, whereas NLPHL lacks reed-stern-berg cells but is characterized by the presence of lymphocyte-predominant cells, also termed as popcorn cells[2]. Non Hodgkin lymphomas are heterogeneous group of malignancies of the lymphoid system. Based on world health organization classification of hematological and lymphoid tumors, these disease have been classified as B cell and T cell neoplasm. B cell lymphoma accounts for approximately 90% of all lymphomas, and the 2 most common histological disease entities are follicular lymphoma and diffuse large B cell lymphoma[3]. Approximately 55000 to 60000 new cases of Non Hodgkin lymphoma are diagnosed annual in the United State according to the study of Non Hodgkin lymphoma: diagnosis and treatment 2005[3]. There has been a global increase in the lymphoma cases were a study done in United States revealed that from the year 2000 to 2007, 16710 new cases of only Hodgkin lymphoma were recorded in SEER registries. Also in the study done in USA showed in 8490 new cases of HL and it accounted for 1320 death by 2010[4]. In the study done in Tanzania were cancer incidence were reported from the year 2008-2016, gave a total of 2772 cases were Non burkitt Non Hodgkin lymphoma had 17.3% of all cancer cases and burkitt lymphoma had 16.5% of the cancer cases. Thus showing the severity of lymphoma cases in Tanzania particularly the Non Hodgkin lymphoma. Lymphoma patients in our locality presents late to the hospital compared to the western and European based patients. This is due various factors like economic, social and cultural. The delay of being diagnosed predisposes them to abnormal presentation from that expected presentations from Western and European patients. This requires a need of accessing the treatment modalities and possible outcomes of our local patients to develop an efficient treatment plan for these patients. Treatment modality as mentioned earlier refers to the set of interventions done to a patient with a purpose of improving the health condition or attaining complete cure of a particular disease. The treatment modalities in lymphoma patients are the radiation therapy, chemotherapy and the combination therapy as modified in the current information[5]. Currently we lack a standardized treatment protocol which can be used to treat our local patients. This raises a need to access the adapted treatment modalities and highlight the best protocol which can be used to suit our local patients. Like any other health condition, lymphoma has mortality. The mortality of the lymphoma is influenced by various factors like the type of the lymphoma, the stage of the disease, the time for treatment, failure of treatment and even complications arising from the treatment.[6]. In our locality we lack enough information concerning the mortality of lymphoma and the possible causes. This creates an area of weakness in accessing in general management of such patients. 1.2 Problem statement Lymphomas in Tanzania carries more than 33.8% of the cancer diagnosed as from a study done from the year 2008 to 2016[7]. The increase in number of lymphoma patients rises the concern on the treatment modalities used, since our patients are provided with the treatment modalities which are European and Western based. As a nation, there is a need to develop our own treatment modality which will suit the reality of the disease in our country. Also lymphoma patients in our locality present late to the hospital and some have a delay in receiving treatment, this creates a unique presentation of lymphoma in our locality hence adding up to the need of creating a standard treatment modality of lymphoma. Also, there has been lack of enough information concerning the mortality of lymphoma patients in our setting hence creating a need of it to be assessed too Due to this there is a need to access the treatment modalities and the mortality of these patients in our locality and possibly develop a standardized treatment modality and local data for mortality of lymphoma cases. 1.3 Rationale of the study The findings from this study will highlight the best treatment modality which can be locally used hence used in developing local treatment modality and in creating policies which will modifying the cancer treatment guideline provided by the Tanzanian Ministry of health. Also this study will provide data on the mortality of lymphoma patients in our locality. This information can be used in creating policies, campaigns and more studies in this particular subject for advancing the knowledge, awareness and care for the lymphoma patients. 1.4 Research question What are the treatment modalities and mortality of patients diagnosed to have lymphoma at Bugando Medical Centre, Oncology department? 1.5 Study Objectives 1.5.1 General Objective Determining the treatment modalities and mortality of patients diagnosed to have lymphoma at Bugando Medical Centre, Oncology department. 1.5.2 Specific Objectives 1. To determine the treatment modalities of patients diagnosed to have lymphoma at Bugando Medical Centre, Oncology department. 2. To determine the mortality of the patients diagnosed to have lymphoma at Bugando Medical Centre, Oncology department ER -