Time To Relapse And Its Predictors Among Non-Hodgkin’s Lymphoma Treated Patients In Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Background: Non-Hodgkin Lymphomas are a heterogeneous group of lymph proliferative malignancies that have a far greater predilection to disseminate to extra nodal locations. It is a cancer that starts in white blood cells called lymphocytes, which are part of the immune system and the most common types were large B cell, follicular, mantle, chronic lymphocytic lymphoma. Objective: The objective of this study was to determine time to relapse and its predictors among non- Hodgkin’s lymphoma treated patients in Saint Paul’s Hospital Millennium Medical College Addis Ababa, Ethiopia, 2024 Methods: A retrospective follow up study using Consecutive sampling technique was employed among 287 non-Hodgkin’s lymphoma treated patients in Saint Paul’s Hospital Millennium Medical College from February to March 2024. Data extraction form was structured by reviewing patient records. Data were collected by trained staffs. Data were coded and entered to Epi-Data V.3.1 and export to IBM Statistical Package for the Social Sciences V.25 for analysis. Kaplin-Meier curve was used to estimate time to relapse and log rank test to compere time to relapse between two or more groups. Cox–proportional hazard assumption was checked graphically by log-log plot and it meets the assumption that the hazard follows the Cox and Snell residual around 45 degrees and statistically using Global goodness of fit test. Multivariable cox proportional hazard regression model used to detect association between outcome variable and predictors and adjusted hazard ratio with 95% confidence interval, p-value < 0.05 was reported as significant predictors of relapse for Non-Hodgkin’s Lymphoma. Results: A study participant of 287 included in this study with 95.6% response rate. The median age of study participants at diagnosis was 51 years. The incidence rate of relapse was 2.2 relapse per 100 person- months of observation. The median time to relapse was 37.0 months [95% CI: 33.340-40.660] Age [AHR=2.28; 95% CI:1.45-3.60] stage III-IV malignancy [AHR=2.48; 95% CI:1.22-5.05], having Comorbidity [AHR=1.68; 95% CI:1.21-2.35], performance status/ECOG/ 3-5[AHR=1.44; 95% CI: 1.01- 2.05] and elevated lactated dehydrogenase level [AHR=1.76; 95% CI: 1.05-2.96] were significantly associated with relapse of non-Hodgkin’s lymphoma. Conclusion: In this study incidence density of relapse and median time to relapse was low. Age, stage, comorbidity, lactated dehydrogenase, and performance status were found predictors of relapse for non- Hodgkin’s lymphoma.