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
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 betwe...
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2021-08-01
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doaj-95a5b54e6cc44bd4853ad22ac502e3c22021-08-28T04:48:01ZengElsevierEClinicalMedicine2589-53702021-08-0138100998Applicability 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 LankaSaman Hewamana0Lakmali Kandabadage1Thurairajah Skandarajah2Natasha Peiris3Sobitha Abeyaratne4Gehan Arseculeratne5Eranga Perera6Mahesh Harischandra7Ananda Wijewickrama8Gnani Somasundaram9Vadivelu Srinivasan10Surjit Somiah11Priyankara Jayawardena12Rohini Wadanamby13Geethani Galagoda14Chathuri Jayasinghe15Chandu De Silva16Sanjeewa Munasinghe17Bandula Wijesiriwardena18Jayantha Balawardena19Clinical Haematology Unit, Lanka Hospital, Colombo, Sri Lanka; Correspondence: Dr. Saman Hewamana, Clinical Haematology Unit, Lanka Hospitals, 578, Elwitigala Mawatha, Colombo 05, Sri Lanka.Lanka Hospital, Colombo, Sri LankaNational Cancer Institute, Colombo, Sri LankaAsiri Surgical Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaAsiri Surgical Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaNational Institute of Infectious Diseases, Angoda, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaNational Hospital of Sri Lanka, Sri LankaLanka Hospital Diagnostics, Colombo, Sri LankaLanka Hospital Diagnostics, Colombo, Sri LankaUniversity of Sri Jayewardenepura, Colombo, Sri LankaFaculty of Medicine, University of Colombo, Colombo, Sri LankaMilitary Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaSir John Kotelawala Defence University, Werahera, Colombo, Sri LankaBackground:: 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. Funding: None.http://www.sciencedirect.com/science/article/pii/S2589537021002789 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Saman Hewamana Lakmali Kandabadage Thurairajah Skandarajah Natasha Peiris Sobitha Abeyaratne Gehan Arseculeratne Eranga Perera Mahesh Harischandra Ananda Wijewickrama Gnani Somasundaram Vadivelu Srinivasan Surjit Somiah Priyankara Jayawardena Rohini Wadanamby Geethani Galagoda Chathuri Jayasinghe Chandu De Silva Sanjeewa Munasinghe Bandula Wijesiriwardena Jayantha Balawardena |
spellingShingle |
Saman Hewamana Lakmali Kandabadage Thurairajah Skandarajah Natasha Peiris Sobitha Abeyaratne Gehan Arseculeratne Eranga Perera Mahesh Harischandra Ananda Wijewickrama Gnani Somasundaram Vadivelu Srinivasan Surjit Somiah Priyankara Jayawardena Rohini Wadanamby Geethani Galagoda Chathuri Jayasinghe Chandu De Silva Sanjeewa Munasinghe Bandula Wijesiriwardena Jayantha Balawardena 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 EClinicalMedicine |
author_facet |
Saman Hewamana Lakmali Kandabadage Thurairajah Skandarajah Natasha Peiris Sobitha Abeyaratne Gehan Arseculeratne Eranga Perera Mahesh Harischandra Ananda Wijewickrama Gnani Somasundaram Vadivelu Srinivasan Surjit Somiah Priyankara Jayawardena Rohini Wadanamby Geethani Galagoda Chathuri Jayasinghe Chandu De Silva Sanjeewa Munasinghe Bandula Wijesiriwardena Jayantha Balawardena |
author_sort |
Saman Hewamana |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publisher |
Elsevier |
series |
EClinicalMedicine |
issn |
2589-5370 |
publishDate |
2021-08-01 |
description |
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. Funding: None. |
url |
http://www.sciencedirect.com/science/article/pii/S2589537021002789 |
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