Applicability of protocols from high-income countries in a resource limited setting; real world data of histopathology, clinical features and long-term outcome of Hodgkin Lymphoma in Sri Lanka.

Autor:	Hewamana S; Clinical Haematology Unit, Lanka Hospital, Colombo, Sri Lanka., Kandabadage L; Lanka Hospital, Colombo, Sri Lanka., Skandarajah T; National Cancer Institute, Colombo, Sri Lanka., Peiris N; Asiri Surgical Hospital, Colombo, Sri Lanka., Abeyaratne S; Lanka Hospital, Colombo, Sri Lanka., Arseculeratne G; Lanka Hospital, Colombo, Sri Lanka., Perera E; Asiri Surgical Hospital, Colombo, Sri Lanka., Harischandra M; Lanka Hospital, Colombo, Sri Lanka., Wijewickrama A; National Institute of Infectious Diseases, Angoda, Sri Lanka., Somasundaram G; Lanka Hospital, Colombo, Sri Lanka., Srinivasan V; Lanka Hospital, Colombo, Sri Lanka., Somiah S; Lanka Hospital, Colombo, Sri Lanka., Jayawardena P; National Hospital of Sri Lanka, Sri Lanka., Wadanamby R; Lanka Hospital Diagnostics, Colombo, Sri Lanka., Galagoda G; Lanka Hospital Diagnostics, Colombo, Sri Lanka., Jayasinghe C; University of Sri Jayewardenepura, Colombo, Sri Lanka., De Silva C; Faculty of Medicine, University of Colombo, Colombo, Sri Lanka., Munasinghe S; Military Hospital, Colombo, Sri Lanka., Wijesiriwardena B; Lanka Hospital, Colombo, Sri Lanka., Balawardena J; Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka.
Jazyk:	angličtina
Zdroj:	EClinicalMedicine [EClinicalMedicine] 2021 Jul 06; Vol. 38, pp. 100998. Date of Electronic Publication: 2021 Jul 06 (Print Publication: 2021).
DOI:	10.1016/j.eclinm.2021.100998
Abstrakt:	Background: : There is a significant disparity in global cancer care and out-come between countries. We aimed to provide data on characteristics, average cost of treatment and survival estimates in patients with Hodgkin Lymphoma in Sri Lanka. Methods: All patients diagnosed with Hodgkin Lymphoma between 01.05.2013 and 01.10.2020 were included in the analysis. Findings: Classical Hodgkin Lymphoma(cHL) diagnosed in 85%; 68% presented with B symptoms and 61% had advanced stage of disease. Treatment was discontinued by 23% either before or just after starting treatment of whom 72% percent were females. The complete response (CR) rate of patients who continued treatment was 86% while the estimated five-year survival rate is 92%. Seventeen percent of these patients died but only two percent due to Hodgkin Lymphoma or associated treatment in the group which continued treatment compared to 45% in the group who defaulted treatment (p-value 0.0002). Five-year survival rate of patients who defaulted treatment was 50% while patients who continued treatment have an estimated five-year survival rate of 90%. Average cost of first line treatment was between US$ 2280 and US$ 7642. First treatment failure may incur substantially higher health care costs. Interpretation: This is the only well characterized study on long-term survival of patients with Hodgkin Lymphoma in Sri Lanka. We have shown that it is possible to successfully apply western treatment and supportive care protocols to the local population. This published data will help to bench mark and improve the treatment and develop blood cancer care in the local setting. Competing Interests: The authors have no conflict of interest for the publication of this study. (© 2021 The Author(s).)
Databáze:	MEDLINE
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