Survival Outcome and Prognostic Factors among Adult Patients with Non- Hodgkin Lymphoma Treated in Selected Comprehensive Hospitals of Amhara Region, Northwest Ethiopia: A Retrospective Cohort Study, 2024

Abstract

Introduction: Worldwide, the burden of non-Hodgkin lymphoma (NHL) has attracted significant attention due to its widespread prevalence. In Sub-Saharan Africa, it is the commonest and most serious public threat. In Ethiopia, it is labeled as a major prevalent and deadly cancer. Unfortunately, studies reporting survival rates and prognostic factors of NHL patients remain scarce in Ethiopia, particularly, in our study region. Objective: To investigate the survival outcome and prognostic factors among patients with NHL treated at selected oncology units in Amhara regional hospitals, in northwest Ethiopia. Methods: A hospital-based retrospective follow-up study was conducted at selected oncology centers of Amhara regional hospitals. All study participants diagnosed with NHL were included from August 1, 2019, to August 1, 2024, GC. A prepared questionnaire was utilized to gather data through medical records review and telephone interviews. Kaplan-Meier survival analysis with a life table was conducted to estimate survival probabilities. Log-rank tests were done to compare survival time between variable groups. Bivariate and multivariate analyses were performed using the Cox proportional hazards model, with statistical significance declared at a p-value of ≤0.05. Result: A total of 169 patients with NHL participated in this study, with 94 (55.6%) being male and 111 (65.7%) aged ≤60. Over half of the patients 96 (56.8%) had high-grad lymphoma, with diffuse large B-cell lymphoma being the most common type (27.2%). The overall 5-year survival rate for NHL was 28.0%, with a median survival of 36.1 months (95% CI: 33–48). In multivariate Cox regression analysis, significant independent predictors of mortality included age over 60 years (AHR=2.6 [1.4-4.8], 0.002), performance status ≥2 (AHR=2.2 [1.2-4.1], 0.014), advanced clinical stage (III-IV) (3.2 [1.6-7.8], 0.002), presence of B-symptoms (AHR=2.1[1.1-3.9], 0.027), and lactate dehydrogenase levels (LDH) ≥250 u/L (AHR=2.4 [1.2-4.6], 0.01). Conclusion and Recommendation: The overall survival rate for the NHL was generally low. Strong predictors of survival outcomes for NHL patients were age >60, performance status ≥2, presence of B-symptoms, clinical stage (III-IV), and LDH ≥250 u/L. The study highlights the importance of patient stratification, advanced therapies, and early detection program, which in turn enhancing patient survival rates.