Meeting the challenge of hematologic malignancies in sub-Saharan Africa.

Publication Type:

Journal Article

Source:

Blood, Volume 119, Issue 22, p.5078-5087 (2012)

Keywords:

2012, April 2012, Center-Authored Paper, Clinical Research Division, Public Health Sciences Division, Vaccine and Infectious Disease Division

Abstract:

Cancer is a leading cause of death and disability in sub-Saharan Africa, and will eclipse infectious diseases within the next several decades if current trends continue. Hematologic malignancies, including non-Hodgkin lymphoma (NHL), leukemia, Hodgkin lymphoma (HL), and multiple myeloma account for nearly 10% of the overall cancer burden in the region, and incidence of NHL and HL are rapidly increasing as a result of human immunodeficiency virus (HIV). Despite an increasing burden, mechanisms for diagnosing, treating, and palliating malignant hematologic disorders are inadequate. In this review, we describe the scope of the problem, including the impact of endemic infections such as HIV, Epstein-Barr virus (EBV), malaria, and Kaposi sarcoma-associated herpesvirus (KSHV). We additionally describe current limitations in hematopathology, chemotherapy, radiotherapy, hematopoietic stem cell transplantation (HSCT), and supportive care and palliation. We review contemporary treatment and outcomes of hematologic malignancies in the region, and outline a clinical service and research agenda which builds on recent global health successes combating HIV and other infectious diseases. Achieving similar progress against hematologic cancers in sub-Saharan Africa will require the sustained collaboration and advocacy of the entire global cancer community.