Table of Contents
Lymphoma
Volume 2012 (2012), Article ID 904367, 9 pages
http://dx.doi.org/10.1155/2012/904367
Review Article

AIDS-Related Non-Hodgkin's Lymphoma in Sub-Saharan Africa: Current Status and Realities of Therapeutic Approach

1Section of Haematology and Blood Transfusion, Department of Human Pathology, College of Health Sciences, University of Nairobi, Nairobi, Kenya
2Departments of Oncology and Pharmacology, Moi University School of Medicine, Eldoret, Kenya
3Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
4Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN 46202, USA
5Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA

Received 24 February 2012; Revised 30 March 2012; Accepted 7 June 2012

Academic Editor: Jan Delabie

Copyright © 2012 Peter M. Mwamba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Today AIDS-related non-Hodgkin's lymphoma (AR-NHL) is a significant cause of morbidity and mortality in HIV-infected patients the world over, and especially in sub-Saharan Africa. While the overall incidence of AR-NHL since the emergence of combination antiretroviral therapy (cART) era has declined, the occurrence of this disease appears to have stabilized. In regions where access to cART is challenging, the impact on disease incidence is less clear. In the resource-rich environment it is clinically recognized that it is no longer appropriate to consider AR-NHL as a single disease entity and rather treatment of AIDS lymphoma needs to be tailored to lymphoma subtype. While intensive therapeutic strategies in the resource-rich world are clearly improving outcome, in AIDS epicenters of the world and especially in sub-Saharan Africa there is a paucity of data on treatment and outcomes. In fact, only one prospective study of dose-modified oral chemotherapy and limited retrospective studies with sufficient details provide a window into the natural history and clinical management of this disease. The scarcities and challenges of treatment in this setting provide a backdrop to review the current status and realities of the therapeutic approach to AR-NHL in sub-Saharan Africa. More pragmatic and risk-adapted therapeutic approaches are needed.