Non-Hodgkin′s lymphoma

Is India ready to incorporate recent advances in day to day practice

Saraschandra Vallabhajosyula, Gunjan Baijal, B. M. Vadhiraja, Donald Fernandes, M. S. Vidyasagar

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background : Non Hodgkin′s Lymphoma (NHL) cure rates are increasing and morbidities are decreasing, with more active pharmacological agents and technological advancements. In spite of this, India is still battling with the prejudices of an economically and educationally impoverished patient base. Methods and Results : We analyzed NHL cases from 2000 to 2006 using data from case sheets. Of 303 cases, only 100 patients had complete workup and received some form of treatment. For 203 patients, reasons for non-compliance were: financial constraint (119), distance from center (38), inability of physician to provide guarantees of cure (13), poor prognosis/fear of recurrence (28)), preferences for alternate medicine (5). Most common investigations that could not be afforded for staging were whole body CT scans and bone marrow aspiration and biopsy. Thirteen patients were in stage III and 53 in Stage IV. The most common regimen was CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). Forty-five patients did not complete six courses of CHOP and 35 patients had significant delay. Reasons for delay were intermittent availability of cash (35), intolerable toxicities (30), absence of supportive care (21), given-up attitudes (17). Eighty-three patients suffered Grade III/IV debilitating toxicities. Overall survival at five years was 50%. Conclusions : NHL in India is no different from the developed world. However, there are disparities in survivorship and outcomes, due to un-affordability and attitudes of the patients. Therefore, we suggest the development of Community Health Insurance Schemes (CHIs), with the hospital as the nodal center to address the above mentioned issues.

Original languageEnglish
Pages (from-to)36-40
Number of pages5
JournalJournal of Cancer Research and Therapeutics
Volume6
Issue number1
DOIs
Publication statusPublished - 01-01-2010

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Non-Hodgkin's Lymphoma
India
Whole Body Imaging
Needle Biopsy
Vincristine
Health Insurance
Patient Compliance
Prednisolone
Doxorubicin
Cyclophosphamide
Fear
Survival Rate
Bone Marrow
Medicine
Pharmacology
Morbidity
Physicians
Recurrence
Survival

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Vallabhajosyula, Saraschandra ; Baijal, Gunjan ; Vadhiraja, B. M. ; Fernandes, Donald ; Vidyasagar, M. S. / Non-Hodgkin′s lymphoma : Is India ready to incorporate recent advances in day to day practice. In: Journal of Cancer Research and Therapeutics. 2010 ; Vol. 6, No. 1. pp. 36-40.
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Non-Hodgkin′s lymphoma : Is India ready to incorporate recent advances in day to day practice. / Vallabhajosyula, Saraschandra; Baijal, Gunjan; Vadhiraja, B. M.; Fernandes, Donald; Vidyasagar, M. S.

In: Journal of Cancer Research and Therapeutics, Vol. 6, No. 1, 01.01.2010, p. 36-40.

Research output: Contribution to journalArticle

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