Epidemiology, clinicopathological profile, treatment patterns and survival outcomes of non-Hodgkin lymphoma: a 10-year single-institution retrospective study

Authors

  • Dorafiona Swer Department of Radiation Oncology, Regional Institute of Medical Sciences, Imphal, Manipur, India
  • Kilari Lakshmi Tirumala Gowtham Department of Radiation Oncology, Regional Institute of Medical Sciences, Imphal, Manipur, India
  • Sunita Devi Akoijam Department of Radiation Oncology, Regional Institute of Medical Sciences, Imphal, Manipur, India
  • Benjamin Malsawmtluanga Department of Radiation Oncology, Mizoram State Cancer Institute, Aizawl, Mizoram, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260956

Keywords:

Non-Hodgkin lymphoma, DLBCL, Epidemiology, Retrospective study, Treatment patterns, Survival

Abstract

Background: Non-Hodgkin lymphoma (NHL) is a heterogeneous group of malignancies with wide variation in clinical presentation and outcomes. Data from resource-limited settings on clinicopathological characteristics, treatment patterns, and outcomes remain limited.

Methods: This retrospective study included 692 patients with histologically confirmed NHL treated at a tertiary government hospital over a 10-year period. Demographic details, clinicopathological features, treatment modalities, and outcomes were extracted from medical records and radiotherapy registers using a predefined data collection form. Analyses were performed using descriptive statistics based on available data without imputation.

Results: The median age at diagnosis was 55.5 years, with a male predominance (male-to-female ratio ~1.2:1). Diffuse large B-cell lymphoma was the most common histological subtype, accounting for 56.3% of patients with documented histology. Ann Arbor staging was available in 422 patients, of whom 67.3% presented with advanced-stage disease (stage III–IV). Chemotherapy was administered in 60.1% of patients, predominantly using CHOP-based regimens. Radiotherapy was delivered with radical or consolidative intent in a substantial proportion of patients, while others received palliative radiotherapy. At last follow-up, 16.8% of patients were alive, 20.1% had died, and a significant proportion were lost to follow-up or had undocumented survival status. Kaplan-Meier survival analysis was not performed due to inconsistent documentation of follow-up dates.

Conclusions: This large single-institution study demonstrates a high burden of advanced-stage NHL at presentation in a low-resource setting, with diffuse large B-cell lymphoma as the predominant subtype. Outcomes were influenced by delayed presentation, limited access to targeted therapies, and substantial loss to follow-up. Strengthening early diagnosis, access to comprehensive oncologic care, and follow-up systems is essential to improve outcomes in similar settings.

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References

International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today. Available at: https://gco.iarc.fr/today. Accessed on 15 December 2025.

Nair R, Varghese C, Rajan B. Epidemiology of non-Hodgkin lymphoma in India. Oncol Hematol Rev. 2016;12:41-50.

Yeole BB. Trends in the incidence of non-Hodgkin’s lymphoma in India: analysis of cancer registry data. Asian Pac J Cancer Prev. 2008;9:615-20.

Gogia A, Sharma A, Kumar L. Diffuse large B-cell lymphoma: institutional analysis from India. Indian J Hematol Blood Transfus. 2018;34:65-74. DOI: https://doi.org/10.4103/sajc.sajc_65_18

Singh D, Singh G, Gaur K. non-Hodgkins lymphoma in Northern India-a clinicopathologic study. Indian J Pathol Microbiol. 2018;61:85-91.

Kumar L, Nair R. Real-world outcomes of lymphoma from India. Asian Pac J Cancer Care. 2022;7:83-92. DOI: https://doi.org/10.3389/fonc.2022.922370

Coiffier B, Lepage E, Briere J. CHOP chemotherapy plus rituximab in elderly DLBCL patients. N Engl J Med. 2002;346:235-42. DOI: https://doi.org/10.1056/NEJMoa011795

Unni M, Mohanti BK, Deo SVS. Adult non-Hodgkin’s lymphoma patients: experience from a tertiary care cancer centre in North East India. J Indian Med Assoc. 2015;113(8):541-5.

WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edition. Lyon: IARC; 2016.

Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457-81. DOI: https://doi.org/10.1080/01621459.1958.10501452

Von Elm E, Altman DG, Egger M. The STROBE statement: guidelines for reporting observational studies. PLoS Med. 2007;4:296. DOI: https://doi.org/10.1371/journal.pmed.0040296

Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood. 2006;107(1):265-76. DOI: https://doi.org/10.1182/blood-2005-06-2508

Sathishkumar K, Chaturvedi M, Das P, Stephen S, Mathur P. Burden of cancers in India: Estimates of cancer crude incidence, YLLs, YLDs and DALYs for 2021 and 2025. Cancer Epidemiol. 2022;76:102082.

Armitage JO. The aggressive peripheral T-cell lymphomas: 2015. Am J Hematol. 2015;90(7):665-73. DOI: https://doi.org/10.1002/ajh.24076

Nair R, Arora N, Mallath MK. Epidemiology of non-Hodgkin’s lymphoma in India. Oncology. 2016;91(1):18-25. DOI: https://doi.org/10.1159/000447577

Babu KG, Lokesh KN, Lokanatha D. Clinicopathological profile and treatment outcomes of non-Hodgkin lymphoma: Experience from a tertiary care cancer centre in India. Indian J Med Paediatr Oncol. 2015;36(1):38-42.

Sharma A, Sengar M, Menon H. Non-Hodgkin lymphoma: Clinicopathological profile and outcome in an Indian tertiary care centre. Asian Pac J Cancer Prev. 2015;16(17):7779-84.

Pfreundschuh M, Trümper L, Osterborg A. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma. Lancet Oncol. 2006;7(5):379-91. DOI: https://doi.org/10.1016/S1470-2045(06)70664-7

Tsang RW, Gospodarowicz MK. Radiotherapy for localized aggressive lymphomas. Hematol Oncol. 2000;18(1):1-12.

Cheson BD, Fisher RI, Barrington SF. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: The Lugano classification. J Clin Oncol. 2014;32(27):3059-68. DOI: https://doi.org/10.1200/JCO.2013.54.8800

The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329(14):987-94. DOI: https://doi.org/10.1056/NEJM199309303291402

Zucca E, Roggero E, Bertoni F, Cavalli F. Primary extranodal non-Hodgkin's lymphomas. Blood. 1997;89(10):3649-60. DOI: https://doi.org/10.1093/jnci/89.18.1328

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Published

2026-03-30

How to Cite

Swer, D., Gowtham, K. L. T., Akoijam, S. D., & Malsawmtluanga, B. (2026). Epidemiology, clinicopathological profile, treatment patterns and survival outcomes of non-Hodgkin lymphoma: a 10-year single-institution retrospective study. International Journal of Research in Medical Sciences, 14(4), 1484–1490. https://doi.org/10.18203/2320-6012.ijrms20260956

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Original Research Articles