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T-cell/Histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare pathology, uncommon in children population and the few cases reported, had wide range clinical presentations, including advanced stage, extranodal involvement and bad prognosis. Authors report a case of a 16-year-old male patient with no medical history, who presented a single left axillary adenopathy. T-cell/Histiocyte-rich large B-cell lymphoma was diagnosed by immunohistochemistry and was classified good prognosis. A RCHOP-based chemotherapy was performed with good progress. Authors hope to contribute to the literature on THRLBCL and draw the attention of practitioners to its occurrence in the pediatric population.

T-cell/Histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare pathology, uncommon in the children population, and the few cases reported had a wide range of clinical presentations, including advanced stage, extranodal involvement, and bad prognosis. The authors report a case of a 16-year-old male patient with no medical history, who presented a single left axillary adenopathy. T-cell/Histiocyte-rich large B-cell lymphoma was diagnosed by immunohistochemistry and was classified good prognosis. RCHOP-based chemotherapy was performed with good progress. The authors hope to contribute to the literature on THRLBCL and draw the attention of practitioners to its occurrence in the pediatric population.

Non-Hodgkin lymphomas (NHL) are underestimated causes of cancer in West Africa where chronic viral hepatitis and HIV are endemic. While the association with HIV infection has already been characterized, limited information is available on the association between chronic viral hepatitis and NHL in sub-Saharan Africa. A case-control study was conducted in referral hospitals of Abidjan (Cote d’Ivoire) and Dakar (Senegal). Cases of NHL were matched with controls on age, gender and participating site. The diagnosis of NHL relied on local pathological examination completed with immunohistochemistry. HIV, HBV and HCV serology tests were systematically performed. A conditional logistic regression model estimated the associations by the Odds Ratio (OR) with their 95% confidence interval (CI). A total of 117 NHL cases (Abidjan n = 97, Dakar n = 20) and their 234 matched controls were enrolled. Cases were predominantly men (68.4%) and had a median age of 50 years (IQR 37-57). While Diffuse Large B-cell lymphoma were the most reported morphological type (n = 35) among mature B-cell NHL, the proportion mature T-cell NHL (30%) was high. The prevalence figures of HBV, HCV and HIV infection were 12.8%, 7.7% and 14.5%, respectively among cases of NHL. In multivariate analysis, HBV, HCV and HIV were independently associated with NHL with OR of 2.23 (CI 1.05-4.75), 4.82 (CI 1.52-15.29) and 3.32 (CI 1.54-7.16), respectively. Chronic viral hepatitis B and C were significantly associated with NHL in West Africa. Timely preventive measures against HBV infection and access to curative anti-HCV treatment might prevent a significant number of NHL.

Background. Vaso-occlusive crisis (VOC) is the primary cause of hospitalization in patients with sickle cell disease. Treatment mainly consists of intravenous morphine or nonsteroidal anti-inflammatory drugs (NSAIDs), which have many dose-related side effects. The question arises as to whether vascular electrical stimulation therapy (VEST) could be effective or not on VOCs. Objective. To measure the effectiveness and safety of VEST in reducing the median time spent in severe VOC. Methods. We conducted a phase II, single blinded, randomized, controlled, triple-arm, comparative trial. We included thirty (30) adult patients with severe vaso-occlusive crisis. The study arms were divided as follows: our control group (group 0) constituted of 10 patients followed with conventional therapy (Analgesics + Hydration + NSAIDs), while 20 patients were divided equally into two interventional arms—10 patients followed with VEST + Analgesics + Hydration (group 1) and the other 10 patients followed with VEST + Analgesics + Hydration + NSAIDs (group 2). The primary efficacy endpoint was median time to severe crisis elimination. The secondary end points were median time to end-of-crisis, median tramadol consumption, progress of the haemoglobin level over 3 days, side effects, and treatment failure. Results. The age ranged from 14 to 37 years, including 23 women. We noted a beneficial influence of the VEST on the median time to severe crisis (VAS greater than 2) elimination; 17 hours (group 1) against 3.5 hours (group 2) p = 0.0166 and 4 hours (group 3) with p value = 0.0448. Similar significant results were obtained on the diminution of total duration of the crisis (VAS over 0) and median tramadol consumption in patients in the interventional arms. Conclusion. These statistically significant results in the interventional arms suggest that VEST could be an alternative treatment of VOC in sickle cell patients.

Resume Introduction Le diagnostic de la leucemie myeloide chronique repose sur la presence de la translocation t(9,22). Les anomalies cytogenetiques additionnelles peuvent exister au diagnostic et posseder un interet pronostique. Les auteurs ont evalue la relation entre ces anomalies chromosomiques additionnelles, la presentation clinique et la reponse therapeutique. Methode Dans une etude retrospective et comparative de 2005 a 2015, au CHU de Yopougon, 51 cas de leucemie myeloide ont ete selectionnes, dont 22 cas avec anomalies chromosomiques additionnelles. Resultats Treize types d’anomalies additionnelles au Ph1 ont ete detectes dans un groupe, avec un âge median de 39 ans (13–73) , un sex-ratio de 1,4 et une classe sociale basse (49 %). Le delai median de consultation est de 13 mois (2–29). Une hepatomegalie (54 % ; p = 0,05) ; une fievre (81,8 % ; p = 0,0017) ; des douleurs osseuses (63,6 % ; p = 0,0001) ; des adenopathies (27,3 % ; p = 0,014) ; un mauvais etat general (OMS > 1 [77,3 % ; p = 0,001]), un index de Sokal eleve (63,6 % ; p = 0,0019), une hypereosinophilie > 5 % (72,7 ; p = 0,02) et une blastose circulante ont ete retrouves plus frequents dans le groupe avec anomalies additionnelles. Traites avec l’imatinib mesylate, nous avons obtenu 13,6 % de remission hematologique et 22,7 % de remission cytogenetique (p = 0,02). La survie moyenne etait relativement courte (20 mois vs 76,4 mois ; Log-rank Conclusion La presence d’une anomalie additionnelle constitue un element pejoratif refractaire a l’imatinib.

Resume Contexte L’atteinte maxillo-faciale a ete la premiere decrite dans le lymphome de Burkitt en 1958 par Denis Parsons Burkitt. Les atteintes abdomino-pelviennes en particulier ovariennes sont de plus en plus observees par l’evolution des techniques d’imagerie. Notre etude avait pour objectif de decrire les aspects epidemiologiques, cliniques, therapeutiques et evolutifs du lymphome de Burkitt endemique a localisation ovarienne. Methodologie Vingt dossiers de lymphome de Burkitt ovarien diagnostiques dans le service d’hematologie clinique du CHU de Yopougon sur une periode de 19 ans (aout 1995-mars 2015) ont ete retrospectivement analyses. Les parametres epidemiologiques, cliniques, therapeutiques et evolutifs ont ete etudies. Resultats Le lymphome de Burkitt ovarien representait 20,41 % de la population atteinte de lymphome de Burkitt et 38,46 % chez les patientes atteintes de lymphome de Burkitt. L’âge moyen etait de 20,4 ans avec des extremes de 6 et 38 ans. Les principaux motifs de consultation etaient l’alteration de l’etat general (85 %) et la masse pelvienne (80 %). 75 % avaient des signes B. La masse ovarienne etait bilaterale dans 60 % des cas, heterogene dans 75 % des cas. 55 % des patients avec un stade III de Murphy. Toutes les patientes traitees par chimiotherapie etaient en remission incomplete (100 %). On notait 10 % de vivants, et 60 % de deces. 83,33 % des patientes decedees avaient recu moins de 6 cures de chimiotherapie. Conclusion Le lymphome de Burkitt endemique a localisation ovarienne est le plus souvent de diagnostic tardif et de mauvais pronostic. L’amelioration de sa prise en charge necessite un diagnostic precoce.

Background: The antiphospholipid antibody syndrome (APL) was rarely evoked as abortion etiology in black Africa. Case Report: The authors reported a case of a 36-year-old female with a medical history of leg ulcer who presented five episodes of recurrent abortion. The diagnosis was oriented to obstetrical etiologies, and three uterine cervix cerclages were realized with failure. As a result of pancytopenia which wasthe main reason of consultation, the diagnosis was made with immunology test showing a high titer of antiphospholipid antibody and lupus anticoagulant. The patient was treated with corticosteroids, immunosuppressive agents, aspirin, and heparin. The 6th pregnancy was free from complications and led to the birth of a living child. Conclusion: This case calls on practitioners to systematically search for the antiphospholipid antibody syndrome during the investigation of spontaneous miscarriages for diagnosis and early management. Contexte : Le syndrome des anticorps antiphospholipides est l’une des etiologies des fausses couches rarement evoquee en premiere intention, sous diagnostiquee en Afrique Noire. Presentation de Cas : Les auteurs rapportent l’observation d’une femme de 36 ans, aux antecedents d’ulcere de la jambe gauche, suivie au service de gyneco-obstetrique pour des fausses couches a repetition totalisant cinq (5) episodes. Le diagnostic initial etait oriente vers les causes gyneco-obstetricales, lesquelles trois cerclages du col ont ete realises avec echec. La survenue d’une pancytopenie qui etait le motif majeur de consultation de la patiente a permis de porter le diagnostic de syndrome des anticorps antiphospholipides lupiques par un titrage significatif des anticorps antiphospholipides et des anticorps antinucleaires de specifie anti DNA. Le traitement avec les corticoides, immunosuppresseurs, l’aspirine et l’heparine a permis une evolution favorable conduisait une 6e grossesse avec succes. Conclusion : Ce travail interpelle les praticiens a rechercher systematiquement le syndrome des anticorps antiphospholipides devant toutes fausses couches spontanees en vue d’un diagnostic et prise en charge precoce.

The maxillo-facial attack was the first described in the Burkitt lymphoma in 1958 by Denis Pearsons Burkitt. Abdominopelvic disorders, particularly ovarian localization are observed more and more by the developments of imagery technics. Our study aimed to describe the epidemiologic, clinical, therapeutic and evolutive aspects of ovarian localization in the endemic Burkitt lymphoma.Twenty files of ovarian Burkitt lymphoma diagnosed in the clinical service of hematology TH of Yopougon during the period August 1995-March 2015 (19 years) were retrospectively analyzed. The epidemiologic, clinical, therapeutic and evolutive parameters were studied.Ovarian Burkitt lymphoma accounted for 20.41% of the population with Burkitt lymphoma and 38.46% for patients with Burkitt lymphoma. The average age was 20.4 years with extremes of 6 and 38 years. The main reasons for consultation were general impairment (85%) and pelvic mass (80%). 75% were in group B clinical scalability. The ovarian mass was bilateral in 60% of cases, heterogeneous in 75% of cases. There was a clear predominance of stage III of Murphy (55%). On the evolutionary level all the patients treated by chemotherapy were in incomplete remission (100%). 10% were alive. 83.33% of the deceased patients had received less than 6 courses of chemotherapy.The diagnosis of ovarian endemic Burkitt lymphoma is most often delayed diagnosis and poor prognosis. Improving its management requires early diagnosis.

The diagnosis of chronic myeloid leukemia is based on the presence of translocation t(9,22). Additional cytogenetic abnormalities may exist at diagnosis and have prognostic value. The authors evaluated the relationship between these additional chromosomal abnormalities, clinical presentation, and therapeutic response.In a retrospective and comparative study from 2005 to 2015, at Yopougon university hospital, 51 cases of myeloid leukemia were selected, including 22 cases with additional chromosomal abnormalities.Thirteen types of additional Ph1 abnormalities were detected in one group, with a median age of 39years (13-73); a sex ratio of 1.4 and a low social class (49%). The median consultation time is 13months (2-29). Hepatomegaly (54%, P=0.05); fever (81.8%, P=0.0017); bone pain (63.6%, P=0.0001); lymphadenopathies (27.3% P=0.014); poor general condition [WHO1 (77.3%, P=0.001)], high Sokal index (63.6%, P=0.0019), eosinophilia5% (72.7, P=0.02) and circulating blastosis were found more frequent in the group with additional abnormalities treated with imatinib mesylate. We obtained 13.6% hematologic remission and 22.7% cytogenetic remission (P=0.02). The average survival was relatively short (20months vs. 76.4months, Log-rank0.0001). We deplored a high death rate (59.1%).The presence of an additional anomaly constitutes a pejorative element refractory to imatinib.

Background: West Africa is recognized as the elective focus of hemoglobin C. The S and C combination in the same patient gives a major sickle cell syndrome. In our country, very few series dealing with the evolutionary features of this SC form have been published contrary to the homozygous SS form. The aim of this study was to describe the evolutionary profile of double heterozygous SC sickle cell patients.Methods: This was a retrospective and prospective study with descriptive and analytical purpose of 174 SC sickle cell patients.Results: The median age was 26 years with extremes of 6 years and 57 years. 96% of patients had less than 4 vaso-occlusive seizures per year. The evolutionary complications were mainly ischemic (56.30%) and infectious (39.10%). Among ischemic complications, sickle cell retinopathies and aseptic osteonecrosis are the most common with 59.20% and 31.63% respectively. Infectious complications were dominated by ENT (36.76%) and osteoarticular (35.29%) infections. Only age had an influence on the occurrence of ischemic complications (p = 0.0001). The probability of survival at 5 years was 99.38% and that at 20 years was 91.57%. The overall survival was not influenced by evolutionary complications.Conclusions: Infectious and ischemic evolutionary complications show the importance of vaccination and an early screening program.

Background: Although a blood genetic disease, sickle cell disease (SCD) leads to a chronic vasculopathy with multiple organ involvement. We assessed arterial stiffness in SCD patients and looked for associations between arterial stiffness and SCD-related vascular complications. Methods: The CADRE (Coeur Artères et Drepanocytose, ie, Heart Arteries and Sickle Cell Disease) study prospectively recruited pediatric and adult SCD patients and healthy controls in Cameroon, Ivory Coast, Gabon, Mali, and Senegal. Patients underwent clinical examination, routine laboratory tests (complete blood count, serum creatinine level), urine albumin/creatinine ratio measure, and a measure of carotid-femoral pulse wave velocity (cf-PWV) and augmentation index (AI) at a steady state. The clinical and biological correlates of cf-PWV and AI were investigated by using a multivariable multilevel linear regression analysis with individuals nested in families further nested in countries. Results: Included were 3627 patients with SCD and 943 controls. Mean cf-PWV was lower in SCD patients (7.5±2.0 m/s) than in controls (9.1±2.4 m/s, P 0 than in SC-Sβ + phenotypes. AI, corrected for heart rate, increased more rapidly with age in SCD patients and was higher in SCD than in control adults. cf-PWV and AI were independently associated with age, sex, height, heart rate, mean blood pressure, hemoglobin level, country, and hemoglobin phenotype. After adjustment for these correlates, cf-PWV and AI were associated with the glomerular filtration rate and osteonecrosis. AI was also associated with stroke, pulmonary hypertension, and priapism, and cf-PWV was associated with microalbuminuria. Conclusions: PWV and AI are deeply modified in SCD patients in comparison with healthy controls. These changes are independently associated with a lower blood pressure and a higher heart rate but also with the hemoglobin phenotype. Moreover, PWV and AI are associated with several SCD clinical complications. Their prognostic value will be assessed at follow-up of the patients.

African Burkitt lymphomas (BL) are highly aggressive lymphomas mainly affecting children and young adults in Africa. This lymphoma was marked by its high sensitivity to chemotherapy in comparison to Sporadic Burkitt lymphoma. In this study, we evaluated the treatment response and survival of patients with CMA protocol. Eighty-five of the 105 children registered were evaluated for response; there were 46 boys and 39 girls, whose age at diagnosis ranged from 3 to 18 years (median 11 years), admitted to the Hematology National Teaching Hospital of Abidjan in the period 1998-2008 with a diagnosis of BL on histological review and who were given CMA chemotherapy with curative intent are included in this analysis. CMA protocol is a low intermediate regimen of 3 drugs [Cytarabin (ara-C), Methotrexate (MTX), and Cyclophosphamide] with CNS-directed treatment by intrathecal MTX, ara-C and corticosteroid. Fifty-five of 85 patients obtained CR after induction therapy and 10 after 3 supplementary cycle because of partial response. The overall complete remission was 76%. Fifty-three of patients were alive in first CR at a median survival rate period of 2 years (range 82 days to 9 years) and are continuously disease free from Burkitt lymphomas. Twelve patients relapse after CR and died of lymphoma progression. More than 32 patients died, as a result of lymphoma progression. Among the 32 dead, 10 were in Murphy stage IV and all the patients who presented bone marrow involvement died. The projected 5-year overall survival rate was 62%. In conclusion, CMA protocol shows the high sensitivity of African Burkitt lymphoma. This can be considered as a successful result for people living in poor socio-economic conditions with no health insurance.

Sickle cell disease is a genetic disease characterized by the synthesis of an abnormal haemoglobin called haemoglobin S. It is the most frequent of the hereditary anomalies of haemoglobin and occurs most commonly in individuals of African descent. Various treatments have considerably improved its prognosis, prolonging the survival of patients, especially those with the most severe, homozygous form. The objective of thisstudy is to describe the epidemiologic, clinical, and laboratory characteristics as well as the disease course and available treatments in adults (aged 21 years or older). This retrospective, descriptive, analytic and non-comparative study included 48 adults of both sexes with homozygous sickle cell disease. Their mean age was 26.1 years (range: 21 to 56 years, and sex ratio 1.3. In all, 70.8% had clinical anaemia, 83.3% were subicteric or icteric and 8.3% had hepatomegaly. Spleen size was normal in 41.7% of patients, and atrophic in 37.5%. No case of splenomegaly was noted and 8.3% had been splenectomised. Haemoglobin rates ranged from 4 g/dL to 12.7 g/dL with an average of 9.5 g/dL, haemoglobin S levels from 83 to 93% with an average of 85.3%, and haemoglobin F levels from 3.5 to 17% with an average of 10.6%. The percentage with fewer than three crises (vasooclusive or haemolytic or both) in a year was 68.7%; 27.1% had from three to five crises, and 4.2% more than five. Disease complications included anaemia in 43.7%, infections in 18.8% and ischaemia in 16.7%; 20.8% had no complications. Age at the beginning of treatment was younger than 5 years in 56.25%, from 5 to 10 years in 29.2%, and older than 10 years in 14.6%. Medical follow-up was regular for 68.7% and irregular for 31.2%. Vaccination was up to date in 58.3. Most patients (83.3%) adhered to their maintenance treatment. In all, 41.7% had not had any blood transfusions, 54.2% had had one or two transfusions, and 4.2% three or more. We compared the patients aged 26 years or younger with those older than 26 and studied the influence of age on different disease variables. Age did not affect the frequency of crises (p = 0.368) or of infections (p = 0.116), the rates of haemoglobin (p = 0.221), haemoglobin S (p = 0.44), or haemoglobin F (p = 0.35), or complications (p = 0.56). Nevertheless, we noted that the frequency of crises, infections, and anaemic complications were higher among the younger patients. Early treatment, regular medical follow-up, maintenance treatment and vaccination have all improved the prognosis of homozygous sickle cell disease considerably. These patients have reached adulthood with relatively few chronic complications.

Il s’agissait d’une etude retrospective a visee descriptive et analytique dont l’objectif etait de decrire les caracteristiques cliniques therapeutiques et evolutives des patients atteints de leucemie lymphoide chronique. Sur un total de 56 patients, L’âge moyen etait de 62 ans avec des extremes allant de 38 a 84 ans avec un sex-ratio de 1,24. Vingt-neuf patients etaient au stade A de binet contre respectivement 11 et 16 pour les stades B et C. Au plan therapeutique, 44,64 % des patients ont recu le protocole COP, 39,29 % pour la mono- /chimiotherapie (chlorambucil) et 16,08 % pour le mini-CHOP. La reponse complete a ete observee dans 51,78 % des cas. Le deces est survenu chez 29 patients. La moyenne de survie etait de 8,22 ans avec une probabilite de survie a cinq ans de l’ordre de 58,8 %. En analyse univariee, les facteurs de mortalite etaient l’âge avance superieur a 62 ans, la splenomegalie de types IV et V de Hackett, l’existence d’adenopathie, l’hepatomegalie, l’hyperleucocytose sanguine superieure a 100 000/μL, l’hyperlymphocytose superieure a 63 000/μL, l’anemie inferieure a 10 g/dL, la thrombopenie inferieure a 100 000/μL, le pourcentage de lymphocyte medullaire superieur a 73 % et les stades avances de Binet B et C. En analyse multivariee, les facteurs independants qui ont un impact reel sur la survie sont l’âge, les adenopathies, l’hepatomegalie, et la leucocytose sanguine.

Resume Nous rapportons les resultats du traitement par le protocole CMA (cyclophosphamide, methotrexate, Aracytine ® ) renforce de 26 patients atteints de lymphome de Burkitt a localisation maxillofaciale dans une etude retrospective de janvier 2000 a decembre 2007 et prospective de janvier a septembre 2008. Le but de cette etude etait d’evaluer les resultats du traitement par le protocole CMA renforce des localisations maxillofaciales. L’âge moyen etait de 7,89 ans, avec un sex-ratio de 2,71. La reponse globale au traitement etait de 92,3 % avec 57,7 % de remission complete et 34,6 % de remission incomplete. Le taux d’echec etait de 7,7 %. La morbidite liee au traitement etait essentiellement d’ordre hematologique (84,6 %) et hydroelectrolytique (84,6 %). L’evolution s’est faite vers le deces dans 30,8 %, et 15,4 % ont ete perdus de vue. Le suivi median etait de 18,2 mois. La mediane de survie etait de 7,4 mois. La reponse au traitement etait liee a la compliance therapeutique ( p p = 0,01).

We retrospectively studied 30 cases of multiple myeloma in patients under the age of 65, diagnosed from 1991 to 2005 in the clinical hematology department of the University Hospital of Yopougon that is a hospital incidence of 2.9 cases/year. The age of patients ranged from 34 to 64 years, with a mean age of 49 years and a sex ratio of 1.73. The professional activity was variable with 3% of radiographers and 10% of farmers. Clinically, the dominant sign was bone pain in 83% of cases. Myeloma was secretory in 93% of cases. It was Ig G-type in 86%, kappa-type in 66% of cases. 86% of patients were anemic, 20% had creatinine >20 mg/L, and 10% had serum calcium >120 mg/L. Geodes were found in 80% of cases. 53% were at stage III of DURIE and SALMON. Complications were infectious (33%), renal (20%), and hemorrhagic (7%). Chemotherapy regimens were VAD (10%), VMCP (30%), and VMCP/VBAP (60%) with 47% of partial responses, 33% of stable disease, and 7% of very good quality partial responses. The outcome developed towards death in 37% and causes of death were renal in 46% of cases. The median survival was only 5.1 months.

Imatinib mesylate provides good results in the treatment of CML in general. But what about the results of this treatment in CML associated with additional cytogenetic abnormalities at diagnosis among black Africans? For this, we retrospectively studied 27 cases of CML associated with additional cytogenetic abnormalities, diagnosed in the department of clinical hematology of the University Hospital of Yopougon in Côte d'Ivoire, from May 2005 to October 2011. The age of patients ranged from 13 to 68 years, with a mean age of 38 years and a sex ratio of 2. Patients were severely symptomatic with a high Sokal score of 67%. CML in chronic phase accounted for 67%. The prevalence of additional cytogenetic abnormalities was 29.7%. There were variants of the Philadelphia chromosome (18.5%), trisomy 8 (14.8%), complex cytogenetic abnormalities (18.5%), second Philadelphia chromosome (14.8%), and minor cytogenetic abnormalities (44.4%). Complete hematologic remission was achieved in 59%, with 52% of major cytogenetic remission. The outcome was fatal in 37% of patients. Death was related in 40% to hematologic toxicity and in 30% to acutisation. The median survival was 40 months.

Diffuse large B-cell lymphomas have been little studied in black Africans. The purpose of our study was to determine the characteristics and results of the management of these lymphomas. Patients and Methods. In a descriptive and analytic retrospective study we studied the medical records of 63 patients with diffuse large B-cell lymphoma hospitalized during the period from 1991 to 2007. The diagnosis was made after lymph node or organ biopsy. Response to treatment, OS, PFS, and toxicity were studied. The complete response has been analyzed univariate and multivariate analysis. Results. The median age was 42 years. The sex ratio was 2. The HIV serology was positive in 11 cases, and 8 patients had antiretroviral therapy. In 71% the lymphoma was at stages III and IV of Ann Arbor. IPI was ≥3 in 65%. Complete remission was achieved in 43%. Only 43% of patients had had a good compliance. Progression-free survival at 3 years was 32%, and overall survival at 3 years was 50%. 13% of patients were lost to follow up, and 51% of them died. In terms of analysis the complete remission rate was influenced by the stage of Ann Arbor ( 𝑃 < 0 . 0 0 0 1 ), biological b symptoms ( 𝑃 < 0 . 0 1 ), the IPI ( 𝑃 < 0 . 0 0 0 1 ), and the socioeconomic standing ( 𝑃 = 0 . 0 0 1 ). In multivariate analysis, only IPI and stage of Ann Arbor influence the complete remission.

We reported in this study a treatment results about 36 Africans patients with follicular lymphoma. The average age of patients was 18 to 73 years old with a median age at 50.83 years old and a sex ratio of 1. Clinical characteristics of patients are mainly represented by advance stage with 70% of stage III and IV of Ann Arbor classification. Histological, we mainly notified follicular lymphoma constituted of small cells 50%, followed by mixed follicular and large cells lymphomas with respectively 27.78 and 22.22%. Using varieties of therapeutics regiments, we obtained 41.67% of complete remission. There were significant correlations between complete remission and histology subtypes. Indeed, the follicular lymphomas constituted by large cells and mixed cells had higher rate of complete remission with respectively 46.67% and 40% in relation with those of small cells with a higher failure rate. Median follow-up was 24 months, the estimated 5-years overall survival and event-free survival were 22%. After a long period, 25 cases of death have been reported, 5 cases of losing sight and 6 patients are still alive and following treatment. Our results are lowers than the reported case in developing country. This none satisfying was in relation with the lower socio-economical level of the main part of the patients. The short survival delay time of our patients didn't permit time to observe transformation case in diffuse large cell lymphomas.