5 year old girl with malignant lymphoblastic lymphoma: Challenges of managing haematological malignancies in a developing country

Amiwero, C ; Okuku, G. ; Adeboye, M. A. N. ; Aina, O. (2011)


Background: Lymphoblastic lymphoma (LBL) is a neoplasm of lymphoblasts. The condition is predominantly lymph node–based disease arising from immature T cells in 85-90% of cases and immature B cells in the remainder. The lymphoma is aggressive, progresses rapidly, and often presenting as stage IV disease in more than 70% of patients. This disease makes up approximately 20% of childhood NHL Objective: To show case the management of childhood lymphoblastic lymphoma and the handicap faced by the oncologists and pathologists. Methods: A review of the index case was carried out at the paediatric department of Federal Medical Centre, Bida, Nigeria. This review took into cognisance patient’s demographic bio data, case history, general and physical examination, various investigations, methods of diagnosis and the type treatment. A comprehensive analysis and account of events before and after the commencement of chemotherapy were also reviewed. Results: This case identifies a 5 year old girl with aggressive malignant lymphoma; lymphoblastic type and the myriad of limitations faced by oncologists and pathologists in the management of haematological malignancies. Socio-cultural, financial (cost implications for the patient for both investigative and therapeutic interventions), inadequate resources and facilities were identified as some of the constraints leading to inadequate management and poor outcome in patients with this condition. Conclusion: Given the limitations associated with the management of cancers in this part of the world, efforts on the part of government and non-governmental agencies are necessary to strengthen and upgrade the existing facilities in various hospitals. The social welfare departments of tertiary hospitals should be adequately funded to meet the demand of this group of patients.