exudates and Lymphoma--Non-Hodgkin

Published epidemiological studies of haematological cancers are few. Hereby we present a 20-year epidemiological data of haematological cancers in Sarawak from a population-based cancer registry.. Haematological cancer cases with ICD-10 coded C81-C96 and ICD-O coded /3 diagnosed from 1996 to 2015 were retrieved from Sarawak Cancer Registry. Adult was defined as those 15 years and above. Incidence rate (IR) was calculated based on yearly Sarawak citizen population stratified to age, gender, and ethnic groups. Age-standardised IR (ASR) was calculated using Segi World Standard Population.. A total of 3,947 cases were retrieved and analysed. ASR was 10 and male predominance (IR ratio 1.32, 95%CI 1.24,1.41). Haematological cancers generally had a U-shaped distribution with lowest IR at age 10-14 years and exponential increment from age 40 years onwards, except acute lymphoblastic leukaemia (ALL) with highest IR in paediatric 2.8 versus adult 0.5. There was a significant difference in ethnic and specific categories of haematological cancers, of which, in general, Bidayuh (IR ratio 1.13, 95%CI 1.00, 1.27) and Melanau (IR ratio 0.54, 95%CI 0.45, 0.65) had the highest and lowest ethnic-specific IR, respectively, in comparison to Malay. The ASR (non-Hodgkin lymphoma, acute myeloid leukaemia, ALL, chronic myeloid leukaemia, and plasma cell neoplasm) showed a decreasing trend over the 20 years, -2.09 in general, while Hodgkin lymphoma showed an increasing trend of + 2.80. There was crude rate difference between the 11 administrative divisions of Sarawak.. This study provided the IR and ASR of haematological cancers in Sarawak for comparison to other regions of the world. Ethnic diversity in Sarawak resulted in significant differences in IR and ASR.

Topics: Adolescent; Adult; Child; Female; Hematologic Neoplasms; Humans; Incidence; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Malaysia; Male; Multiple Myeloma; Registries

To retrospectively report the clinical outcomes of non-Hodgkin's Lymphoma (NHL) patients post high dose therapy (HDT) with autologous haematopoietic stem cell transplant (AHSCT) and determine whether upfront transplant, which is a first-line consolidative treatment with induction chemotherapy, would be a feasible modality in a resource-limited country.. The medical records for NHL patients who had undergone HDT followed by AHSCT from October 1997 to November 2016 from two hospitals in Klang Valley, Malaysia were obtained from the medical record database and analysed retrospectively through statistical analysis.. A total of 148 patients were retrospectively identified post-AHSCT, where the majority of whom had B cell lymphoma (53.4%). Majority of patients (88.5%) were in complete remission before AHSCT. The overall survival (OS) and event-free survival (EFS) at 3 years were 68.9% and 60.8%, respectively. The major cause of death was disease progression at 73.9%, while transplant-related mortality was 15.2%, with a median follow-up period of 179.5 weeks.. Our study illustrates the promising outcomes of HDT with AHSCT in NHL patients in a resource-limited country. We recommend larger studies to be conducted in the future with a longer duration of follow-up to validate our findings.

Topics: Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, Non-Hodgkin; Malaysia; Retrospective Studies; Transplantation, Autologous; Treatment Outcome

Large consortia efforts and genome-wide association studies (GWASs) have linked a number of genetic variants within the 6p21 chromosomal region to non-Hodgkin lymphoma (NHL). Complementing these efforts, we genotyped previously reported SNPs in the human leukocyte antigen (HLA) class I (rs6457327) and class II (rs9271100, rs2647012 and rs10484561) regions in a total of 1,145 subjects (567 NHL cases and 578 healthy controls) from two major ethnic groups in Malaysia, the Malays and the Chinese. We identified a NHL-associated (P

Topics: Adult; Demography; Female; Gene Expression Regulation; Genetic Predisposition to Disease; Herpesvirus 4, Human; Histocompatibility Antigens Class II; Humans; Lymphocytes; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged; Polymorphism, Single Nucleotide; Quantitative Trait Loci

Radioimmunotherapy is an established treatment modality in Non-Hodgkin's lymphoma. The only two commercially available radioimmunotherapies - (90)Y-ibritumomab tiuxetan is expensive and (131)I-tositumomab has been discontinued from commercial production. In resource limited environment, self-labelling (131)I-rituximab might be the only viable practical option. We reported our pioneer experience in Malaysia on self-labelling (131)I-rituximab, substituting autologous haematopoietic stem cell transplantation (HSCT) and a patient, the first reported case, received high dose (131)I-rituximab (6000MBq/163mCi) combined with BEAM conditioning for autologous HSCT.

Topics: Adult; Antibodies, Monoclonal, Murine-Derived; Hematopoietic Stem Cell Transplantation; Humans; Isotope Labeling; Lymphoma, Non-Hodgkin; Malaysia; Middle Aged; Pilot Projects; Radioimmunotherapy; Radiopharmaceuticals; Radiotherapy Dosage; Rituximab; Treatment Outcome

We evaluated the association of two IL10 single nucleotide polymorphisms (SNPs) (rs1800896 and rs1800871) with non-Hodgkin lymphoma (NHL) risk in the three major races of the Malaysian population (Malay, Chinese and Indian; 317 cases and 330 controls). Our initial screening demonstrated that rs1800871 but not rs1800896 was significantly associated with increased NHL risk in Malays (pMalay-Rec = 0.007) and Chinese only (pChinese-Rec = 0.039). Subsequent combined analysis of the Malay and Chinese revealed significant association of rs1800871 with all (ALL) NHL subtypes (pMeta-ALL-NHL-Rec = 0.001), ALL B-cell subtypes (pMeta-ALL-B-cell-Rec = 0.003), diffuse large B-cell lymphoma (DLBCL) subtype (pMeta-DLBCL-Rec = 0.002) and ALL T-cell subtypes (pMeta-ALL-T-cell-Rec = 0.031). SNP rs1800896 showed increased risk only in follicular lymphoma (FL) (pMeta-FL-Dom = 0.0004). We also detected a male-specific association of rs1800871 with increased NHL risk (pMeta-Male-ALL-NHL-Rec = 0.006) in the combined analysis. To our knowledge, this is the first report on the association of IL10 promoter SNPs with NHL susceptibility in the three major races of Malaysia.

Topics: Adult; Aged; Asian People; Case-Control Studies; Female; Genetic Predisposition to Disease; Humans; Interleukin-10; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged; Polymorphism, Single Nucleotide; Promoter Regions, Genetic

Many studies in the literature have shown that Epstein-Barr virus (EBV) is associated with several human lymphoid and epithelial malignancies. However, the prevalence of EBV in non-Hodgkin lymphoma (NHL) of the lower gastrointestinal (GI) tract has not been fully elucidated.. The aim of this study was to determine the presence and distribution of EBV in formalin-fixed paraffin-embedded tissue samples obtained from 18 Malaysian patients diagnosed with NHL of the lower GI tract.. The GI tract lymphoma tissue samples analyzed for the presence of EBV were divided into the following groups: NHL of the small intestine (seven cases); NHL of the ileocecum (ten cases); and NHL of the rectum (one case). The presence of EBV-encoded RNA (EBER) in all of the above tissue samples was tested for using conventional in situ hybridization technology.. Two of 18 cases (11.1%) of NHL of the lower GI tract demonstrated positive signals for EBV/EBER. In the first positive case, EBV/EBER signals were located in lymphoma cells in the serosa layer of the small intestine. In the second EBV/EBER-positive case, EBV/EBER signals were detected in diffuse B-cell lymphoma of the ileocecum.. These findings demonstrate a rare association between EBV and lower GI tract lymphomas in this group of Malaysian patients.

Topics: Adult; Aged; Child; Child, Preschool; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Intestinal Neoplasms; Intestine, Large; Intestine, Small; Lower Gastrointestinal Tract; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged

The pattern of childhood non-Hodgkin's lymphoma (NHL) usually differs in adults. The most common subtypes are lymphoblastic, Burkitt's and anaplastic large cell lymphoma. Recent data indicate that a higher risk of developing lymphoma is associated in children of certain ethnic origins. The difference is probably related to the underlying etiological factors of these diseases, and Epstein-Barr virus (EBV) is a strong candidate. The present study aims to determine the disease pattern of childhood lymphomas in the University Hospital Kuala Lumpur, for a direct comparison to the reported data of adults from the same medical center. A total of 69 and 34 childhood NHL and Hodgkin's lymphomas, respectively, were retrieved. The most common subtypes were lymphoblastic (23 cases), Burkitt's (25 cases) and anaplastic large cell lymphomas (9 cases). Epstein-Barr virus association was more prevalent in B-cell (23%) than T-cell (12%) lymphomas. The most common EBV-associated tumor was Burkitt's lymphoma, and there was an increased risk of EBV association for Burkitt's lymphoma in Chinese patients. In conclusion, the pattern of childhood lymphoma in Malaysia is relatively similar to children elsewhere in the world. The EBV association of B- and T-NHL differs between children and adults from the same medical center because of differences in the subtype composition in these two age groups.

Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Immunohistochemistry; In Situ Hybridization; Infant; Lymphoma, Non-Hodgkin; Malaysia; Male

The pattern of malignant lymphoma is known to vary in different populations. This study aims to elucidate the effect of ethnicity on subtype frequency of non-Hodgkin's lymphoma and EBV association rate.. A total of 232 reconfirmed lymphoma cases in Malaysian patients were retrieved from the archives in the Department of Pathology, University Hospital, Kuala Lumpur. There were 24 (10%) Hodgkin's and 208 (90%) non-Hodgkin's lymphomas, 173 of the latter were in adult group (aged > or = 15 years). The ethnic composition were 41 Malays, 107 Chinese, 21 Indians and four none of the above. A male : female ratio of 2.4 : 1 was observed. Complete immunohistochemical studies in 158 cases revealed 36 (23%) T-cell, 121 (76%) B-cell and one (1%) null-cell phenotype. Seventy-five percent of the T-cell lymphomas were peripheral T/NK-cell types. Among the classifiable lesions, low-grade/indolent lymphomas constituted 17%: 2% were the lymphocytic subtype and 10% were follicular lymphomas. Approximately one-third of the follicular lymphomas occurred in Indian patients. The largest group of high-grade lymphoma was diffuse large B-cell type (46%), followed by peripheral T/NK-cell (18%). A predominance of NK/T-cell lymphomas occurred in Chinese (5/7), and all were EBV associated. Burkitt's lymphoma accounted for 5% (eight cases), all were Chinese males, with a 38% EBV-association rate. The frequency of EBV-associated B-cell lymphoma is three times more common in Chinese than Malays. The EBV positivity rate among lymphomas in ethnic Malay, Chinese and Indian patients was 5%, 15% and 22%, respectively, and in T- and B-cell lymphomas was 36% and 7%, respectively.. This Malaysian series reveals differences in the subtype frequencies of non-Hodgkin's lymphomas and EBV association rate amongst patients of various ethnic groups residing in the same environment.

Topics: Adolescent; Adult; Child; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; In Situ Hybridization; Lymphoma, B-Cell; Lymphoma, Non-Hodgkin; Lymphoma, T-Cell; Malaysia; Male; Prevalence; RNA, Viral

Lymphoma is a relatively common group of neoplasms diagnosed in hospital practice. This study aims to elucidate the pattern of this disease encountered in a public service hospital of the Ministry of Health, Malaysia.. A total of 98 biopsies from 92 patients were retrieved from the archives of Klang General Hospital, from January 1993 to June 1999. The histopathology of these biopsies were reviewed by two pathologists, and confirmed cases were sub-classified according to the WHO proposed scheme. Immunohistochemical staining with a panel of lymphoid antibodies was performed in aid of sub-typing. All cases were screened for Epstein-Barr virus association by in-situ hybridisation technique.. 15 biopsies were excluded from further analysis due to inadequate material for further study or diagnosed as non-lymphoma. The remaining 83 biopsies were from 80 patients. 52 were males and 28 females. The male: female ratio was 1.9:1. There were 64 Malays, 4 Chinese and 12 Indians. The ages of patients ranged from 3 to 86 years with a mean age of 50.5 years. 73.8% of the diagnostic materials were nodal tissue. Fourteen patients had Hodgkin's lymphomas (HL), 6 being mixed-cellularity, 4 nodular-sclerosis, 1 lymphocyte-rich, 2 lymphocyte-depleted, 1 lymphocyte-predominant, and 66 had non-Hodgkin's lymphomas (NHL). The HL: NHL ratio was 1:4.7. Of the 66 cases of NHL, 9 (13.6%) were T- and 57 (86.4%) B-cell types. The most common NHL encountered was diffuse large B-cell type. Follicular-lymphoma constituted 16.7% of these NHL. 77.8% of T-NHL and 10.5% of B-NHL was EBV associated. Double staining of EBER with CD20 and EBER with CD3 in the T-NHL cases showed that in a majority of the cases, EBER-positive large cells did not express the T- or B- cell antigen.. There is a relatively small proportion of T-cell lymphoma in this series of Asian patients. The reason is thought to be the lower utilisation rate of this hospital service by ethnic Chinese, as reflected by the hospital admission data.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Child; Child, Preschool; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Hodgkin Disease; Hospitals, Public; Humans; Lymph Nodes; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged; RNA, Viral

Lymphoma is a highly heterogeneous group of malignant disease. This study aimed to elucidate the pattern of lymphoma in the East Malaysian patient population. 107 cases of confirmed lymphomas from East Malaysian biopsy material were retrieved from the files of the Department of Pathology, University of Malaya, in the 3-year period between 1981 to 1983. With the use of a panel of lymphoid antibodies, the disease was sub-classified using the Rye classification for Hodgkin's lymphoma (HL) and the REAL classification for non-Hodgkin's lymphoma (NHL). All of the cases were tested for the presence of the Epstein-Barr virus by EBER-ISH. There were 11 (10.3%) HL, 80 (74.7%) B-NHL and 16 (15%) T-NHL. The HL:NHL ratio was 1:9. The most common tumour in children was Burkitt's lymphoma 7/13 (53.8%). In the adult group, there were 72/94 (76.6%) B-NHL ¿diffuse large cell type 51 (of which 2 were CD30+), Burkitt's lymphoma 8, follicular lymphoma 5, low grade MALT 2, mantle cell type 1 and not otherwise specified due to poor morphology 5¿, 13/94 (13.8%) T-NHL and 9/94 (9.6%) HL. Of the 9 adult HL, the most common subtype was nodular sclerosis (6, 66.7%). The EBER positive rate in classical HL, T-NHL, BL and B-NHL were 33.3%, 56.3%, 60.0% and 3.1% respectively. In conclusion, the spectrum of lymphoma seen in East Malaysia was rather similar to West Malaysia except for the very low prevalence of peripheral T-cell lymphoma (PTCL) in Sarawak (3.3%).

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Herpesvirus 4, Human; Hodgkin Disease; Hospitals, University; Humans; Incidence; Lymphoma; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged

Non-Hodgkin's lymphoma has increased in incidence in many countries, particularly in the West. Advances in diagnostic methods and the understanding of the disease over time pose a challenge to the interpretation of these trends. The aim of this study was to determine if the disease has increased in Singapore, a newly industrialized Asian country, and to examine the possible factors that may account for any observed changes.. Data from the population-based Singapore Cancer Registry for the period 1968 to 1992 were reviewed to determine time trends based on sex and ethnic group. The Poisson regression model was fitted to the cross-tabulated data to obtain the adjusted incidence density ratios.. A total of 1988 cases of non-Hodgkin's lymphoma were included in the analysis. There was an overall increase in incidence among both Chinese and Malaysians. However, the rate of increase was greater in females (age-standardized rate from 1.8 per 100,000 in 1968-1972 to 4.5 per 100,000 in 1988-1992) than in males (3.2 per 100,000 to 5.9 per 100,000 in the same time periods). Between ethnic groups, Malay females were at higher overall risk compared with their Chinese counterparts (incidence density ratio 1.32; 95% confidence interval, 1.08-1.61). Although a substantial proportion of patients diagnosed with Hodgkin's disease between 1968 and 1972 were reclassified on review, using present criteria, as having non-Hodgkin's lymphoma, it is unlikely that this, and other recent changes in histologic interpretation, could have accounted for an increase of this magnitude.. Non-Hodgkin's lymphoma has increased in incidence among the Chinese and Malay populations in Singapore. The pattern of increase differs from that of the common cancer sites, and suggests the need to look for environmental and genetic factors that have not yet been elucidated.

Topics: China; Ethnicity; Female; Hodgkin Disease; Humans; Incidence; India; Lymphoma, Non-Hodgkin; Malaysia; Male; Poisson Distribution; Population Surveillance; Registries; Regression Analysis; Risk Factors; Sex Factors; Singapore; Time Factors

Epstein-Barr virus (EBV) type B, a less potent transformer of B lymphocytes than type A, has rarely been detected in EBV-associated neoplasms except in AIDS-related lymphomas, in which about 50% of the cases contained this sub-type. In this study we analyzed the association of EBV and the distribution of virus sub-types in Asian non-Hodgkin's lymphoma (NHL) of the upper aerodigestive tract. We studied archival material of 29 NHL cases from Malaysia. B- and T-cell associated antigens were demonstrated by immunohistochemistry, and EBV early RNA EBER-1 was demonstrated using the RNA in situ hybridization technique. EBV was detected in the majority of tumour cells in 11/13 T-NHL but in only 1/16 B-NHL. EBV was sub-typed by single-step polymerase chain reaction of the EBNA-2 gene. This was successful in 9/10 cases of EBER-1-positive tumours and all contained type-A virus only. Our results showed a preponderance of T-cell lymphoma of the upper aerodigestive tract in the ethnic Chinese group of Malaysian patients, and EBV was strongly associated with T-NHL but not with B-NHL. Our results suggest that type-A EBV is the prevalent sub-type in Asian NHL of the upper aerodigestive tract, similarly to findings in Asian nasopharyngeal carcinoma.

Topics: Adult; Aged; Antigens, CD; Antigens, Viral; Base Sequence; Child, Preschool; DNA Primers; DNA-Binding Proteins; Epstein-Barr Virus Nuclear Antigens; Female; Herpesvirus 4, Human; Humans; In Situ Hybridization; Incidence; Lymphoma, Non-Hodgkin; Malaysia; Male; Middle Aged; Molecular Sequence Data; Nasopharyngeal Neoplasms; Oropharyngeal Neoplasms; Palatal Neoplasms; Paranasal Sinus Neoplasms; Polymerase Chain Reaction; Retrospective Studies; Trans-Activators