Malignant lymphomas (ML) and HIV infection in Tanzania

\ud HIV infection is reported to be associated with some malignant lymphomas (ML) so called AIDS-related lymphomas (ARL), with an aggressive behavior and poor prognosis. The ML frequency, pathogenicity, clinical patterns and possible association with AIDS in Tanzania, are not well documented impeding the development of preventive and therapeutic strategies. Sections of 176 archival formalin-fixed paraffin-embedded biopsies of ML patients at Muhimbili National Hospital (MNH)/Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania from 1996-2001 were stained for hematoxylin and eosin and selected (70) cases for expression of pan-leucocytic (CD45), B-cell (CD20), T-cell (CD3), Hodgkin/RS cell (CD30), histiocyte (CD68) and proliferation (Ki-67) antigen markers. Corresponding clinical records were also evaluated. Available sera from 38 ML patients were screened (ELISA) for HIV antibodies. The proportion of ML out of all diagnosed tumors at MNH during the 6 year period was 4.2% (176/4200) comprising 77.84% non-Hodgkin (NHL) including 19.32% Burkitt's (BL) and 22.16% Hodgkin's disease (HD). The ML tumors frequency increased from 0.42% (1997) to 0.70% (2001) and 23.7% of tested sera from these patients were HIV positive. The mean age for all ML was 30, age-range 3-91 and peak age was 1-20 years. The male:female ratio was 1.8:1. Supra-diaphragmatic presentation was commonest and histological sub-types were mostly aggressive B-cell lymphomas however, no clear cases of primary effusion lymphoma (PEL) and primary central nervous system lymphoma (PCNSL) were diagnosed. Malignant lymphomas apparently, increased significantly among diagnosed tumors at MNH between 1996 and 2001, predominantly among the young, HIV infected and AIDS patients. The frequent aggressive clinical and histological presentation as well as the dominant B-immunophenotype and the HIV serology indicate a pathogenic association with AIDS. Therefore, routine HIV screening of all malignant lymphoma patients at MNH is necessary to enable comprehensive ARL diagnosis and formulation of preventive and therapeutic protocols.\u

H & E section of a diffuse large cell lymphoma (DLBCL) high grade NHL; note the high mitotic index blue arrows (× 400)

H & E section of a small cell lymphoma [SCL] which is a low-grade NHL (× 400). H & E section of a Hodgkin's disease mixed cellularity (HDMC) case; note the classical Reed-Sternberg (R-S) cell [blue arrows] and eosinophil cells [black arrows] (× 400). H & E section of a BL; note the "starry-sky" appearance due to tingible-body macrophages [black arrows] (× 200).<p><b>Copyright information:</b></p><p>Taken from "Malignant lymphomas (ML) and HIV infection in Tanzania"</p><p>http://www.jeccr.com/content/27/1/9</p><p>Journal of Experimental & Clinical Cancer Research : CR 2008;27(1):9-9.</p><p>Published online 10 Jun 2008</p><p>PMCID:PMC2438337.</p><p></p

Frequency polygon showing variation of different ML types with time at MNH between 1996 and 2001

Note the increase in frequency of NHL and HD between 1997 and 2000.<p><b>Copyright information:</b></p><p>Taken from "Malignant lymphomas (ML) and HIV infection in Tanzania"</p><p>http://www.jeccr.com/content/27/1/9</p><p>Journal of Experimental & Clinical Cancer Research : CR 2008;27(1):9-9.</p><p>Published online 10 Jun 2008</p><p>PMCID:PMC2438337.</p><p></p

Pie chart showing the proportion of ML serologically screened for HIV antibodies at MNH between 1996 and 2001

Note that a large number of ML at MNH were not screened for HIV.<p><b>Copyright information:</b></p><p>Taken from "Malignant lymphomas (ML) and HIV infection in Tanzania"</p><p>http://www.jeccr.com/content/27/1/9</p><p>Journal of Experimental & Clinical Cancer Research : CR 2008;27(1):9-9.</p><p>Published online 10 Jun 2008</p><p>PMCID:PMC2438337.</p><p></p

Building capacity for sustainable research programmes for cancer in Africa

Cancer research in Africa will have a pivotal role in cancer control planning in this continent. However, environments (such as those in academic or clinical settings) with limited research infrastructure (laboratories, biorespositories, databases) coupled with inadequate funding and other resources have hampered African scientists from carrying out rigorous research. In September 2012, over 100 scientists with expertise in cancer research in Africa met in London to discuss the challenges in performing high-quality research, and to formulate the next steps for building sustainable, comprehensive and multi-disciplinary programmes relevant to Africa. This was the first meeting among five major organizations: the African Organisation for Research and Training in Africa (AORTIC), the Africa Oxford Cancer Foundation (AfrOx), and the National Cancer Institutes (NCI) of Brazil, France and the USA. This article summarizes the discussions and recommendations of this meeting, including the next steps required to create sustainable and impactful research programmes that will enable evidenced-based cancer control approaches and planning at the local, regional and national levels