Hodgkins lymphoma in North Jordan. Does it have a different pattern?

OBJECTIVE: To study the pattern of Hodgkin's lymphoma (HL) in North Jordan, identify the epidemiological features of this disease, and to see if these patterns are unique or follow the patterns seen in developed or developing countries.

METHODS: All of the cases of HL diagnosed at the Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan between January 1996 and September 2002 were retrieved and reviewed histologically. Seventy-five confirmed HL cases were classified according to the WHO classification of hematological malignancies. Data on the age and gender of the patients were correlated with those of the histopathologic types of the disease.

RESULTS: Patients range in age from 3-72 years with a median of 20 years. The young adult population (15-34 years) was the largest group in this study accounting for 45.9% of all cases followed by the childhood group (0-14 years), which accounted for 25.6% of the cases. The age distribution displayed only one peak between 11 and 20 years. Classic HL accounted for 91% of the cases, half of these cases belong to the mixed cellularity (MC) type and 46% belong to the nodular sclerosis (NS) type. The overall male to female ratio was 1.7:1; but the ratio was the highest (3.75:1) among children, and reversed among patients with NS type in the young adult group (0.78:1).

CONCLUSION: The MC and NS types of HL accounted for the vast majority of HL in North Jordan. Similar to other developing countries the MC type of HL was the most common type followed by the NS type. The age distribution displayed a unimodal pattern with a peak between 11 and 20 years of age, which is a decade earlier than the first peak seen in the West. This pattern is also different from developing countries, where HL peaks in children less than 10 years of age. Hodgkin's lymphoma in Jordan appears to have an intermediate pattern between developing countries and the West.