Epidemiology of Lymphoma in Saudi Arabia


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Abdulaziz Rajeh Alanzi

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  • These are malignant tumours of the lymphoid system classifiedseparately from Hodgkin’s lymphoma. Most (70%) areof B cell origin with 30% of T cell origin.
  • The etiology of Hodgkin lymphoma is unknown
  • The etiology of Hodgkin lymphoma is unknown
  • Epidemiology of Lymphoma in Saudi Arabia

    1. 1. Mr.Abdulaziz R. AlanziMedical Student, Al-Imam UniversityRiyadh – Saudi Arabia
    2. 2. Road MapDefinitionClassificationRisk FactorsEtiologyPrevalence – World WidePrevalence – Saudi Arabia
    3. 3. References1. Harrison’s Principles of Internal Medicine Book 17th edition2. Kumar et al: Robbins Basic Pathology Book 8th edition3. World Health Organization (WHO)4. Medscape Reference5. Surveillance Epidemiology and End Results (SEER)6. Cancer Center, University of Kansas7. Right Diagnosis
    4. 4. Definition•Malignant tumors of lymphoidtissue, characterized by the abnormalproliferation of B or T cells in the lymphoidtissue.Source: Kumar et al: Robbins Basic Pathology Book 8E
    5. 5. LymphomaHodgkin’s lymphoma Non-Hodgkin’s lymphomaNodular lymphocyte-predominantHodgkin’s lymphomaClassical Hodgkin’slymphoma:Nodular sclerosis HLLymphocyte-rich HLMixed cellularity HLLymphocyte -depleted HLB cell lymphomas T/NK cell lymphomasPrecursor B celllymphomaMature B celllymphomaPrecursor T celllymphomaMature T/NK celllymphomaThe WHO classification (2001)Source: World Health Organization (WHO)
    6. 6. Non-Hodgkin LymphomaHodgkin LymphomaMore frequent involvement of multiple peripheralnodesMore often localized to a single axial group ofnodes (cervical, mediastinal, para-aortic)Noncontiguous spreadOrderly spread by contiguityMesenteric nodes and Waldeyer ring commonlyinvolvedMesenteric nodes and Waldeyer ring rarelyinvolvedExtranodal involvement commonExtranodal involvement uncommonTable 12-10. Clinical Differences Between Hodgkin and Non-Hodgkin LymphomasSource: Kumar et al: Robbins Basic Pathology Book 8EClassification
    7. 7. • Age: The disease peaks at ages 15 to 40 and at 55 and older.• Exposure to environmental poisons, such as Agent Orange• Family history of the disease, although lymphoma has only a weak geneticlink• Gender: Hodgkin lymphoma is more common in males than females• History of infectious mononucleosis or Epstein-Barr virus• Prolonged use of human growth hormone• Weakened immune system, including infection with HIVSource: http://www.kucancercenter.org/cancer-information/specialties-and-treatment/lymphoma/preventionRF - Hodgkin Lymphoma
    8. 8. • Age: The likelihood of getting NHL increases as you get older.• Bacterial infection: Infection with Helicobacter pylori increases the risk oflymphoma involving the stomach.• Gender: Non-Hodgkin lymphoma is more common in males than females.• Exposure to farming chemicals or fertilizers, chemicals used to dissolverubbers or glues, chemicals used to make rubber products, asbestos andarsenic increases the risk of developing NHL.• Weakened immune system: NHL is most common among those who have animpaired immune system or a severe autoimmune disease. It also occursamong those who take medicines to suppress the immune system followingan organ transplant.• Viral infection: Infection with Epstein-Barr virus or Human ImmunodeficiencyVirus (HIV) increases the risk of developing NHL.RF – Non-Hodgkin LymphomaSource: http://www.kucancercenter.org/cancer-information/specialties-and-treatment/lymphoma/prevention
    9. 9. Source: http://emedicine.medscape.com/article/201886-overview#aw2aab6b2b3Etiology - Hodgkin Lymphoma• EBV, may be involved in the pathogenesis. In as many as50% of cases, the tumor cells are EBV-positive.• Patients with HIV infection have a higher incidence ofHodgkin lymphoma compared with the populationwithout HIV infection.Infectiousagents• Approximately 1% of patients with Hodgkinlymphoma have a family history of the disease.Geneticpredisposition• May have a protective effect againstlymphomagenesis through mechanisms that may beindependent of vitamin DUV radiationexposure
    10. 10. Source: http://emedicine.medscape.com/article/201886-overview#aw2aab6b2b3Etiology – Non-Hodgkin Lymphoma• Epstein-Barr virus (EBV), Human T-cell leukemia virus type 1(HTLV-1) , Hepatitis C virus (HCV), Kaposi sarcoma–associated herpesvirus (KSHV) , Helicobacter pylori infection.Infectious agents• The t(14;18)(q32;q21) translocation is the most commonchromosomal abnormality associated with NHL.Chromosomal translocations• chemicals (eg, pesticides, herbicides, solvents, organicchemicals, wood preservatives, dusts, hair dye), chemotherapy, andradiation exposure.Environmental factors• Congenital immunodeficiency states, AIDS, Celiac disease.Immunodeficiency states• Sjögren syndrome and Hashimoto thyroiditis.Chronic inflammation
    11. 11. Etiology – QWhich of these agents willnot cause HL?• HIV Infection• Genetic predisposition• UV radiation• Non of the above
    12. 12. • Data taken from SEER (Surveillance Epidemiology and EndResults) http seer.cancer.gov• Prevelance includes any person alive on January 1, 2009who had been diagnosed with lymphoma at any point priorto January 1, 2009 and includes persons with active diseaseand those who are cured of their disease.Prevalence – World Wide1- Non-Hodgkin Lymphoma 2- Hodgkin Lymphoma
    13. 13. Non-Hodgkin Lymphoma On January 1, 2009 , in USSource: Surveillance Epidemiology and End Results (SEER) http seer.cancer.gov/statfacts/html/nhl.htmlPrevalence – World Wide1- Non-Hodgkin Lymphoma: 484,336252,111 men 232,225 women
    14. 14. Prevalence – World WideSource: Surveillance Epidemiology and End Results (SEER) http seer.cancer.gov/statfacts/html/nhl.htmlHodgkin Lymphoma On January 1, 2009 , in US2- Hodgkin Lymphoma: 174,90890,425 men 84,483 women
    15. 15. Prevalence – World WideWhich is More common?OrHodgkin Non-Hodgkin
    16. 16. Source: Harrison’s Principles of Internal Medicine 17th editionFigure: Relative Frequency of Lymphoid Malignancies
    17. 17. Prevalence – Saudi Arabia
    18. 18. Source: http://www.rightdiagnosis.com/n/non_hodgkins_lymphoma/stats-country.htmPrevalence – Saudi Arabia
    19. 19. Prevalence – Saudi ArabiaSource: http://www.rightdiagnosis.com/n/non_hodgkins_lymphoma/stats-country.htm
    20. 20. .pdf0611_0600_2009_3_15/1503applications.emro.who.int/emhj/http://Source: WHOPrevalence – Saudi Arabia
    21. 21. d0pa@hotmail.com@AbdulazizEnazihttp://imamu.academia.edu/AbdulazizAlanzi