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Childhood and Adolescence Non-Hodgkin Lymphomas in Low- and Middle-Income Countries

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Abstract

While it is estimated that 80% of childhood cancers occur in low- and middle-income countries (LMIC), the non-Hodgkin lymphomas (NHL) of childhood and adolescence are among the five most common pediatric malignancies worldwide. Recent epidemiological data have demonstrated that the incidence of NHL is significantly higher in many regions throughout the LMIC of the world, with the highest incidence found in the equatorial belt of sub-Saharan Africa, where Burkitt lymphoma (BL) is the most common childhood cancer overall. Other distinct epidemiological features of pediatric NHL in LMIC include the relationship of Epstein–Barr virus (EBV) and malaria to endemic Burkitt lymphoma in Africa, as well as the distinct predominance of EBV-associated T- and NK-cell NHL in Central and South America plus East Asia. This chapter will describe some of the unique patterns of childhood and adolescence NHL in LMIC as well as review clinical data from sub-Saharan Africa and Central and South America. The collective experience of treating pediatric NHL in LMIC highlights the challenges of matching the exceptionally high cure rates achieved in high-income countries amid the limitations in medical resources that persist in LMIC. More precise determinations of the true epidemiology of pediatric NHL in LMIC are needed, as well as adapted treatment protocols that can be safely and effectively delivered across the heterogeneous circumstances worldwide. Improved medical and societal infrastructure and increased multidisciplinary subspecialty expertise are required to bridge the gap between disparate survival outcomes that exist between high income and LMIC. Ultimately, there is a great opportunity to capitalize on the potential for excellent survival outcomes in pediatric NHL and provide curative therapy for all children with NHL across the globe.

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Ozuah, N.W., El-Mallawany, N.K. (2019). Childhood and Adolescence Non-Hodgkin Lymphomas in Low- and Middle-Income Countries. In: Abla, O., Attarbaschi, A. (eds) Non-Hodgkin's Lymphoma in Childhood and Adolescence. Springer, Cham. https://doi.org/10.1007/978-3-030-11769-6_27

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