Journal of Cancer and Tumor International

Primary central nervous system lymphoma (PCNSL) is a very rare and aggressive form of B-cell non- Hodgkin’s lymphoma. It originates but is restricted to the central nervous system (CNS) at the time of diagnosis. Patients typically present with focal neurologic deficits, cranial neuropathies and features of raised intracranial pressure (RICP). Systemic involvement is uncommon in documented cases of PCNSL.

We report a 10-year-old boy who presented with a headache, neck pain and early morning projectile vomiting of eight weeks duration. He developed abnormal behaviours, gait and visual disturbance and lapsed into unconsciousness two days before presentation. He had cranial neuropathies, dilated pupils, papilloedema but had no lymphadenopathy, systemic involvement and no meningeal irritation. There was no background immunosuppression. A diagnosis of suspected cerebral astrocytoma with RICP was made. CNS tuberculosis was also considered. The computerised tomography scan showed multiple homogenous contrast-enhancing lesions with mild peri-lesional oedema in the frontal lobes, left thalamus with effacement of the sulci and Sylvian fissures. All the ventricles appeared normal. He had leucocytosis of 31.9 x 103/uL with neutrophilia. Cerebrospinal fluid analysis revealed elevated protein and lymphocytic infiltrate. Screening for tuberculosis and human immunodeficiency virus (HIV) were negative. A definitive diagnosis of PCNSL was then made. He had intra-thecal steroids and chemotherapy before he succumbed to the illness. Histology at autopsy confirmed the diagnosis of PCNSL. Though rare in children, PCNSL should be considered in any child who presents with features of characteristic mass lesions in the brain with RICP.

Anaplastic large cell lymphoma is a rare malignancy during childhood.  Equally rare are publications of the disease in African children.  We reported two cases which successfully treated by chemotherapy in the pediatric oncology unit at Gabriel Touré Hospital in Bamako, Mali. The clinical course and therapeutic outcomes of the disease in these two children were presented similarly to cases described in the medical literature from other areas of the world. However, further study with a larger number of cases is needed to be confirmed in these results.

Aims: Inhibition of ultraviolet-A and -B (UVA+B) skin tumour formation by topical treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was investigated in SKH-1 hairless mice.

Methodology: A UV skin tumour study was designed. Group of mice were irradiated with daily doses of UVA+B for approximately 10 min per day, 5 days per week for 10 weeks. After this 10-week, there was no further UV-exposure. The integrated UV-A irradiance (280-320 nm) was 2.4 X 10^-4 W/cm² and the UV-B irradiance (320-400 nm) was 1.8 X 10^-3 W/cm². Mice were divided into 4 groups (n=20 per group). Group 1 was treated with methanol; Group 2 received 2% indomethacin in methanol; Group 3 received 2% paracetamol in methanol; Group 4 received 2% flurbiprofen in methanol. All groups received their treatment once a day, five days per week for 25 weeks. Mice were euthanized after 35 weeks.

Results: The test NSAIDs in methanol were effective in reducing the incidence and size of the   skin tumours induced by UVA+B, with a significantly lower average number and/or area of          skin tumours observed in the NSAID-treated mice compared to the methanol control animals (P < .05).

Conclusion: The results support the hypothesis that topically applied indomethacin, paracetamol, and flurbiprofen can provide protection against skin cancer, even when applied well after the skin has been exposed to the damaging effects of UV-light.

Background: Hepatitis C virus (HCV) is a hepatotropic and potentially lymphotropic virus. Chronic HCV infection might be involved in the pathogenesis of non-Hodgkin’s lymphoma (NHL). Aim: to determine the prevalence of HCV infection in patients with NHL and its effect on treatment outcome. Methods: In this retrospective study, two hundred patients presented with NHL were screened for chronic HCV infection by detecting anti-HCV antibody then further confirmation with real-time polymerase chain reaction for HCV-RNA. We compared treatment response, hepatotoxicity, relapse-free survival (RFS) and overall survival (OS) according to HCV infection (NHL with negative HCV RNA group and NHL with positive HCV RNA group).

Results: Median age was 52 years old. Anti-HCV antibodies were detected in 101 patients (50.5%), and HCV-RNA was detected in 97 patients (48.5%). A curative-intent anthracycline-containing regimen as first-line treatments, with rituximab addition, was given in 68 patients. Hepatic toxicity developed in 45 patients. Eight patients (4%) had to discontinue chemotherapy due to severe hepatic impairment (toxicity grade 3–4). HCV infection was not a significant risk factor for hepatic toxicity. There was no significant difference between patients with chronic HCV infection and those without disease regarding the response to treatment. With a follow-up 12 months for patients with positive antibodies for HCV and those with negative antibodies for HCV, there was no significant difference between two the groups as regards relapse and relapse-free survival. Patients with chronic HCV infection did not have significantly different outcome than those without HCV-infection (P <0.05).

Conclusion: HCV infection might not influence the clinical course in patients with NHL and does not affect the treatment response, patient survival and prognosis of NHL.

Lymphoblastic lymphomas (LBL) are malignant proliferations of the lymphoid precursors of T cells mainly. LBL accounts for approximately 2% of all non-Hodgkin’s lymphomas in the developed countries. Until the 1970s, diffuse lymphoblastic lymphoma was considered incurable. With intensive multidrug regimens, the majority of patients can now be cured. Event-free survival (EFS) is 70 to 80% in developed countries.

In Africa, and particularly in Mali, there are few published studies on the management of this type of cancer in children.

The aim of this retrospective study was to evaluate the treatment and outcomes of children with LBL according to the modified EURO-LB 08 protocol at the Pediatric Oncology Unit of the CHU Gabriel Touré of Bamako, Mali. All patients less than 15 years old, with histologic proven LBL treated between October 23, 2009 and April 30, 2016 were included in the study. Ten patients with LBL met the inclusion criteria. LBL accounted for 0.8% of admissions during this period. The age group of 6-11 years represented the majority (n = 7; 70%). The sex ratio was 2.3:1 for girls and boys respectively. Eighty percent of patients had good nutritional status on admission. Polyadenopathy was found in 7 patients (70%). One patient presented with mediastinal mass. Pleural effusion was associated with polyadenopathy in one patient. Stage 3 was predominant (n = 7; 70%). The diagnosis was made by cytology in 80% of patient and histology and immunohistochemistry in 2 patients. Eight patients completed treatment. Grade III neutropenia and anemia were observed in 5 patients. Three patients died from tumor progression during treatment and two patients died from treatment-related toxicity. Three patients were in complete remission at the end of treatment.

Early diagnosis and better availability of anticancer drugs may improve the overall survival rate of patients with LBL in Mali.