Lymphomas in sub‐Saharan Africa – what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research?

Approximately 30 000 cases of non‐Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing in this part of the world, very little is known about lymphomas in Africa. This review provides information regarding the current infrastructure for diagnostics in sub‐Saharan Africa. The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub‐Saharan Africa were based on a review undertaken by a team of lymphoma experts on 159 fine needle aspirate samples and 467 histological samples during their visit to selected sub‐Saharan African centres is presented. Among children (<18 years of age), BL accounted for 82% of all NHL, and among adults, diffuse large B‐cell lymphoma accounted for 55% of all NHLs. Among adults, various lymphomas other than BL, including T‐cell lymphomas, were encountered. The review also discusses the current strategies of the International Network of Cancer Treatment and Research on improving the diagnostic standards and management of lymphoma patients and in acquiring reliable clinical and pathology data in sub‐Saharan Africa for fostering high‐quality translational research.

[1]  I. Magrath,et al.  Long‐term experience with burkitt's lymphoma in uganda , 1980, International journal of cancer.

[2]  E. Kaaya,et al.  Malignant lymphomas (ML) and HIV infection in Tanzania , 2008, Journal of experimental & clinical cancer research : CR.

[3]  D. Burkitt A sarcoma involving the jaws in african children , 1972, The British journal of surgery.

[4]  S. Remick,et al.  AIDS-associated cancer in developing nations , 2004, Current opinion in oncology.

[5]  Michael Hummel,et al.  Gene-expression analysis identifies novel RBL2/p130 target genes in endemic Burkitt lymphoma cell lines and primary tumors. , 2007, Blood.

[6]  I. Magrath Lessons from clinical trials in African Burkitt lymphoma , 2009, Current opinion in oncology.

[7]  L. Leoncini,et al.  Alteration of MicroRNAs Regulated by c-Myc in Burkitt Lymphoma , 2010, PloS one.

[8]  S. Pileri,et al.  Immunoglobulin gene analysis reveals 2 distinct cells of origin for EBV-positive and EBV-negative Burkitt lymphomas. , 2005, Blood.

[9]  L. Leoncini,et al.  B‐cell differentiation in EBV‐positive Burkitt lymphoma is impaired at posttranscriptional level by miRNA‐altered expression , 2010, International journal of cancer.

[10]  E. Castaños-Vélez,et al.  AIDS and non AIDS-related malignant lymphoma in Tanzania. , 2006, African health sciences.

[11]  L. Leoncini,et al.  MYC translocation‐negative classical Burkitt lymphoma cases: an alternative pathogenetic mechanism involving miRNA deregulation , 2008, The Journal of pathology.

[12]  S. Pileri,et al.  Gene expression analysis uncovers similarity and differences among Burkitt lymphoma subtypes. , 2010, Blood.

[13]  W. Klapper,et al.  Diffuse large B-cell lymphoma in pediatric patients belongs predominantly to the germinal-center type B-cell lymphomas: a clinicopathologic analysis of cases included in the German BFM (Berlin-Frankfurt-Munster) Multicenter Trial. , 2006, Blood.

[14]  S. Remick,et al.  Adult Burkitt's lymphoma in patients with and without human immunodeficiency virus infection in Kenya , 2001, International journal of cancer.

[15]  L. Ayers,et al.  Accuracy of Burkitt lymphoma diagnosis in constrained pathology settings: importance to epidemiology. , 2011, Archives of pathology & laboratory medicine.

[16]  J. Esteve,et al.  High‐dose chemotherapy and immunotherapy in adult Burkitt lymphoma , 2008, Cancer.

[17]  R. Spang,et al.  Molecular profiling of pediatric mature B-cell lymphoma treated in population-based prospective clinical trials. , 2008, Blood.