Medical Oncology

, Volume 19, Issue 3, pp 141–150 | Cite as

Lympho-hemopoietic malignancies in India

  • Manisha Bhutani
  • Amish Vora
  • Lalit Kumar
  • Vinod KochupillaiEmail author
Original Article


Available information on lympho-hemopoietic malignancies in India is presented. The incidence of most cancers, including multiple myeloma, lymphomas, and leukemias, is lower compared to that in the West; chronic myelogenous leukemia, however, is higher and the incidence of non-Hodgkin’s lymphoma (NHL) is rising. Most cancers occur at a younger age. Higher frequencies of mixed-cellularity Hodgkin’s disease, diffuse large-cell NHL and T cell acute lymphoblastic leukemia are noted. Most patients present in advanced stages and have poorer prognostic factors. Treatment results are comparable if stagewise distribution and poor prognostic factors are taken into account.

Key Words

Multiple myeloma Hodgkin’s disease non-Hodgkin’s lymphoma leukemia India hematological cancers 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    WHO (1999). Health Situation in the South East Asia Region 1994–1997. Regional Office for SEAR, New Delhi.Google Scholar
  2. 2.
    Magrath, I. and Litvak, J. (1993). Cancer in developing countries: opportunity and challenge. J. Natl. Cancer Inst. 85(11):862–874.PubMedCrossRefGoogle Scholar
  3. 3.
    WHO (1999). World Health Report 1999, Making a difference. Report of the Director General, WHO, Geneva.Google Scholar
  4. 4.
    Indian Council of Medical Research. (2001). National Cancer Registry Programme Consolidated Report of the Population Based Cancer Registries 1990–1996: Incidence and Distribution of Cancer. Indian Council of Medical Research, New Delhi. 2001.Google Scholar
  5. 5.
    Park, K., ed. (2000). Health programmes in India, in Park’s Textbook of Preventive and Social Medicine, 16th ed. Banarsidas Bhanot, Jabalpur, India, pp 305–318.Google Scholar
  6. 6.
    Government of India (1998). Health Information of India 1995 & 1996, DGHS, New Delhi.Google Scholar
  7. 7.
    Parkin, D. M., Whelam, S. L., Ferlay, J., Raymond, L. and Young J. eds. (1997). Cancer Incidence in Five Continents, Vol. VII, pp 804–913. IARC Lyon. 804–913.Google Scholar
  8. 8.
    Chandi, L., Kumar, L., Kochupillai, V., Dawar, R. and Singh, R. (1998). Hodgkin’s disease: a retrospective analysis of 15 years experience at a large referral centre. Natl. Med. J. India 11:212–217.PubMedGoogle Scholar
  9. 9.
    Dinshaw, K. A., Advani, S. H., Gopal, R., Nair, C. N., Talvalker, G. V., Gangadharan, P., et al. (1984). Management of Hodgkin’s disease in Western India. Cancer 54:1276–1282.PubMedCrossRefGoogle Scholar
  10. 10.
    Shanta, D. V., Sastri, L. N., Sagar, T. G., et al. (1982). A review of Hodgkins disease at Cancer Institute Madras. Clin. Oncol. 8(1):5–15.PubMedGoogle Scholar
  11. 11.
    Kennedy, B. J., Fremgen, A. M. and Menck, H. R. (1998). National Cancer. Data Base Report for 1985–89 and 1990–94. Cancer 83(5):1041–1047.PubMedCrossRefGoogle Scholar
  12. 12.
    Hassan, Y. A. and Ezzeldin, M. I. (1991). Hodgkin’s disease in adults in Saudi Arabia. Int. J. Cancer 47:822–826.CrossRefGoogle Scholar
  13. 13.
    Lorraine, L. (1988). Hodgkin’s disease in black Zimbabweans. Cancer 61:189–194.CrossRefGoogle Scholar
  14. 14.
    Ferlay, J., Bray, F., Pisani, P., et al. (2001). GLOBOCAN 2000: Cancer Incidence, Mortality and Prevalence Worldwide, Version 1.0. IARC Cancer Base no. 5, IARC, Lyon.Google Scholar
  15. 15.
    Advani, S. H., Soman, C. S., Talwalkar, G. V., Iyer, Y. S. and Bhatia, H. M. (1978). Multiple myeloma. Review of 231 cases. Indian J. Cancer 15:55–61.PubMedGoogle Scholar
  16. 16.
    Gupta, P., Kochupillai, V., Singh, S., Berry, M., Kumar, L. and Sundaram, K. R. (1995). A twelve year study of multiple myeloma at the All India Institute of Medical Sciences, New Delhi, India. Indian J. Med Pediatr. Oncol. 16(2):108–114.Google Scholar
  17. 17.
    Devessa, S. S., Silverman, D. T., Young, J. L., Jr., Pollack, E. S., Brown, C. C., Horm, J. W., et al. (1987). Cancer incidence and mortality trends among whites in the United States, 1947–84. J. Natl. Cancer Inst. 79:701.Google Scholar
  18. 18.
    Kumar, L., Wadhwa, J. and Kochupillai, V. (2000). Multiple Myeloma: Recent advances, in (ed): Medicine Update UPI-CON 2000 (Pande, M., ed.), pp 207–217, Association of Physicians of India, Saharanpur.Google Scholar
  19. 19.
    Nair, M. K., Varghese, C., Krishnan, E., Sankaranarayanan, R. and Balakrishnan N. (1993). Survival in multiple myeloma in Kerala. Natl. Med. J. India 6(1):7–10.PubMedGoogle Scholar
  20. 20.
    Kyle, R. A. (1975). Multiple myeloma: review of 869 cases. Mayo Clin. Proc. 50:29–40.PubMedGoogle Scholar
  21. 21.
    Wadhwa, J., Kumar, L. and Kochupillai, V. (2002). VAD followed by VMCP: an alternative regimen for multiple myeloma. Med. Oncol. 19:105–108.PubMedCrossRefGoogle Scholar
  22. 22.
    Tribalto, M., Amadoi, S., Cantonetti, M., Franchi, A., Papa, G., Pileri, A., et al. (1985). Treatment of multiple myeloma: a randomized study of three different regimens. Leukemia Res. 9:1043–1049.CrossRefGoogle Scholar
  23. 23.
    Alexanian, R., Barlogie, B. and Tucker, S. (1990). VAD based regimens as primary treatment for multiple myeloma. Am. J. Hematol. 33:86–89.PubMedCrossRefGoogle Scholar
  24. 24.
    Kumar, L., Wadhwa, J. and Kochupillai, V. (2001). Multiple myeloma: recent advances. Indian J. Hematal. Blood Transfusion 19(1):11–16.Google Scholar
  25. 25.
    Evans, A. S., Kirchhoff, L. V., Pannuti, C. S., Carvaltio, R. P. S. and McClelland, K. E. (1980). A case controlled study of Hodgkin’s disease in Brazil. Seroepidemiologic studies in cases and family members. Am. J. Epidemiol. 112:609–618.PubMedGoogle Scholar
  26. 26.
    Roy, P., Vaughan Hudson, G., Vaughan Hudson, B. and Esteve, J. (2000). Long term survival in Hodgkin’s disease patients. Eur. J. Cancer 36:384–389.PubMedCrossRefGoogle Scholar
  27. 27.
    Brousset, P., Chettal, S., Schlaifer, D., Icart, J., Payer, C., Rigal-Huguet, F., et al. (1991). Detection of Epstein-Barr virus messenger RNA in Reed-Sternberg cells of Hodgkin’s disease by the in situ hybridization with biotinylated probes on specially processed modified acetone methyl benzoate xylene (ModA Mex) sections. Blood 77:1781.PubMedGoogle Scholar
  28. 28.
    Glaser, S. L., Lin, R. J., Stewart, S. L., Ambinder, R. F., Jarrett, R. E., Brousset, P., et al. (1997). Epstein-Barr virus-associated Hodgkin’s disease: epidemiologic characteristics in international data. Int. J. Cancer 70:375–382.PubMedCrossRefGoogle Scholar
  29. 29.
    Nandakumar, A., Anantha, N., Venugopal, T., Reddy, S., Padmanabhan, B., Swamy, K., et al. (1995). Descriptive epidemiology of lymphoid and haemopoietic malignancies in Bangalore, India. Int. J. Cancer 63:37–42.PubMedCrossRefGoogle Scholar
  30. 30.
    Bonnett, A., Roder, D., Esterman, A. and McCaul, K. (1991). Epidemiology of Cancer in South Australia. South Australian Cancer Registry, Adelaide.Google Scholar
  31. 31.
    Black, R. J., Sharp, L., Kendrick, S. W., eds. (1993). Trends in Cancer Survival in Scotland, 1968–1990. Information and Statistics Division, Directorate of Information Services, National Health Service in Scotland, Edinburgh.Google Scholar
  32. 32.
    Kushawaha, M. R. S., Chandra, D., Misra, N. C., Misra, P. K. and Agarwal, S. S. (1985). Leukaemias and lymphomas at Lucknow, India. Leukemia Res. 9(6):799–802.CrossRefGoogle Scholar
  33. 33.
    Rabkin, C. S., Devesa, S. S., Zahm, S. H. and Gail, M. H. (1993). Increasing incidence of non-Hodgkin’s lymphoma. Semin. Hematol. 30:28–96.Google Scholar
  34. 34.
    Armitage, J. O., Naugh, P. M., Harris, N. L. and Bierman, P. (2001). Non-Hodgkin’s lymphoma, in Cancer Principles and Practice of Oncology, 6th ed. (Devita, V. T., Hellman, S. and Rosenberg, S. A., eds.), pp 2256–2316. Lippincott William & Wilkins, Philadelphia.Google Scholar
  35. 35.
    Naresh, K. H., Srinivas, V. and Soman, C. S. (2000). Distribution of various subtypes of non-Hodgkin’s lymphoma in India: a study of 2773 lymphomas using R.E.A.L. and WHO Classifications. Ann. Oncol. 11(Suppl. 1):63–67.PubMedCrossRefGoogle Scholar
  36. 36.
    Anderson, J. R., Armitage, J. O. and Weisenburger, D. D. (1998). Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin’s Lymphoma Classification Project. Ann. Oncol. 9:717–720.PubMedCrossRefGoogle Scholar
  37. 37.
    Shih, L. Y. and Liang, D. C. (1991). Non-Hodgkin’s lymphomas in Asia. Hematol. Oncol. Clin. North Am. 5:983–1001.PubMedGoogle Scholar
  38. 38.
    Garg, A., Dawar, A., Agarwal, V., Rustagi, R. K. and Kochupillai, V. (1985). Non-Hodgkin’s lymphoma in Northern India—a retrospective analysis of 238 cases. Cancer 56:972–977.PubMedCrossRefGoogle Scholar
  39. 39.
    Gupta, P., Kochupillai, V. and Bajaj, R. (1993). A randomized trial of CHOP versus COPBLAM-I chemotherapy in advanced, aggressive histology non-Hodgkin’s lymphoma. Hematol. Rev. Commun. 7:77–83.Google Scholar
  40. 40.
    Gupta, P., Kochupillai, V. and Misra, A. (1993). A randomized trial of CHOP versus P-CHOP chemotherapy in advanced, aggressive histology non-Hodgkin’s lymphoma. Hematol. Rev. Commun. 7:85–90.Google Scholar
  41. 41.
    Rani, S., Beohar, P. C., Mohanty, T. K. and Mathur, M. D. (1982). Leukaemic pattern in Delhi—a ten year study of 490 cases. Indian J. Cancer 19:81–86.PubMedGoogle Scholar
  42. 42.
    Shome, D. K., Ghosh, K., Mohanty, D. and Das, K. (1985). Leukaemia in North West India. Acta Haematol. 73:244.PubMedGoogle Scholar
  43. 43.
    Advani, S., Sussawalla, D., Nagaraj Rao, D., Gangadharan, P. and Shetty, P. (1979). A study of 1126 leukaemia cases. Epidemiologic and end-result analysis. Indian J. Cancer 16:8–17.PubMedGoogle Scholar
  44. 44.
    Prakash, S., Ramamurthi, Gopalan, R., and Aurora, A. L. (1981). Leukaemias at Pondicherry. Indian J. Cancer 18:1–6.PubMedGoogle Scholar
  45. 45.
    Dicosta, G., Siddiqui, H. M., Pradhan, R. M. and Gupta, S. S. (1989). Pattern of leukaemias: a ten-year incidence study of 242 cases. J. Postgrad. Med. 35(4):191–195.Google Scholar
  46. 46.
    Verghese, P. R., Elayidom, N. B., Joseph, C. D. and Kumar, S. (1984). Epidemiological observations on leukemia in Kerala (a study of 1016 cases over three years). Indian Haematol. 2:2.Google Scholar
  47. 47.
    Chatterjee, J. B., Ghose, S. and Lay, R. N. (1962). Incidence of leukemia (an analysis of 544 cases studied in Calcutta). J. Assoc. Phys. India 10:673–676.Google Scholar
  48. 48.
    Ries, L. A. G., Kosary, C. L., Hankey, B. E. et al., eds. (1999). SEER Cancer Statistics Review, 1973–1996. National Cancer Institute, Bethesda, MD.Google Scholar
  49. 49.
    Advani, S., Pai, S., Venzon, D., Adde, W., Kurkure, P. K., Nair, C. N., et al. (1999). Acute lymphoblastic leukemia in India: an analysis of prognostic factors using a single treatment regimen. Ann. Oncol. 10:167–176.PubMedCrossRefGoogle Scholar
  50. 50.
    Kamat, D. M., Gopal, R., Advani, S. H., Nair, C. N., Kumar, A., Sarkia, T., et al. (1985). Pattern of subtypes of acute lymphoblastic leukemia in India. Leukemia Res. 9:927–934.CrossRefGoogle Scholar
  51. 51.
    Bhargava, M., Kumar, R., Karak, A., Kochupillai, V., Arya, L. S. and Mohankumar, T. (1988). Immunological subtypes of acute lymphoblastic leukemia in North India. Leukemia Res. 12(8):673–678.CrossRefGoogle Scholar
  52. 52.
    Chandy, M. (1995). Childhood acute lymphoblastic leukemia in India: an approach to management in three-tier society. Med. Pediatr. Oncol. 25:197–203.PubMedCrossRefGoogle Scholar
  53. 53.
    Rajalekshmy, K. R., Abitha, A. R., Pramila, R., Gnanasagar, T., Maitreyan, V., Shanta, V., et al. (1994). Immunophenotyping of acute lymphoblastic leukemia in Madras, India. Leukemia Res. 18(3):183–190.CrossRefGoogle Scholar
  54. 54.
    Ludwig, W. D., Raghavachar, A. and Thiel, E. (1994). Immunophenotypic classification of acute lymphoblastic leukemia. Baillieres Clin. Haematol. 7:235.PubMedCrossRefGoogle Scholar
  55. 55.
    Ramot, B. and Magrath, I. (1982). Hypothesis: the environment is a major determinant of the immunological subtype of lymphoma and acute lymphoblastic leukaemia in children. Br. J. Haematol. 52:183–189.Google Scholar
  56. 56.
    Rajalekshmy, K. R., Abitha, A. R., Pramila, R., Gnanasagar, T. and Shanta, V. (1997). Immunophenotypic analysis of T-cell acute lymphoblastic leukemia in Madras, India. Leukemia Res. 21(2):119–124.CrossRefGoogle Scholar
  57. 57.
    Kochupillai, V., Kataria, S. P., Sharma, V. K., Aggarwal, S., Ranganathan, A., Kumar, L., et al. (1995). Sixteen years study of acute lymphoblastic leukemia in adults at All India Institute of Medical Sciences (AIIMS), New Delhi. Indian J. Med. Pediatr. Oncol. 16:99–107.Google Scholar
  58. 58.
    Walters, T. R., Busho, M. and Sinove, J. (1972). Poor prognosis in Negro children with acute lymphoblastic leukemia. Cancer 29:210–214.PubMedCrossRefGoogle Scholar
  59. 59.
    Oakhill, A. and Mann, J. R. (1983). Poor prognosis of acute lymphoblastic leukemia in Asian children living in the United Kingdom. Br. Med. J. 286:839–841.CrossRefGoogle Scholar
  60. 60.
    Shanta, V., Maitreyan, V., Sagar, T. G., et al. (1996). Prognostic variables and survival in pediatric acute lymphoblastic leukemias: Cancer Institute Experience. Pediatr. Hematol. Oncol. 13:205–216.PubMedGoogle Scholar
  61. 61.
    Appaji, L., Lalitha, N., Aruna, B. S., Padma, Vani, N. K., Srinivas, V., et al. (1994). Acute lymphoblastic leukemia—KM10 experience. Proceedings of XVI International Cancer Congress p 272.Google Scholar
  62. 62.
    Bhargava, M. (1997). Acute lymphoblastic leukemia: Indian Scenario. Postgrad. Med. J. 11:184–190.Google Scholar
  63. 63.
    Sazawal, S., Bhatia, K., Gurbuxani, S., Arya, L. S., Raina, V., Khattar, A., et al. (2000). Pattern of immunoglobulin (Ig) and T-cell receptor (TCR) gene rearrangements in childhood acute lymphoblastic leukemia in India. Leukemia Res 24:575–582.CrossRefGoogle Scholar
  64. 64.
    Gurbuxani, S., Lacorte, J. M., Raina, V., Arya, L. S., Pepen, D., Sazawal, S., et al. (1998). Detection of Bcr-Abl transcripts in acute lymphoblastic leukemia in Indian patients. Leukemia Res. 22(2):77–80.CrossRefGoogle Scholar
  65. 65.
    Amare, P., Gladstone, B., Varghese, C., Pai, S. and Advani, S. (1999). Clinical significance of cytogenetic findings at diagnosis and in remission in childhood and adult acute lymphoblastic leukemia: Experience from India. Cancer Genet. Cytogenet. 110:44–53.PubMedCrossRefGoogle Scholar
  66. 66.
    Inamdar, N., Kumar, S. A., Banavali, S. D., Advani, S., Magrath, I., Bhatia, K., et al. (1998). Comparative incidence of the rearrangement of TEL/AMLI and ALLI genes in pediatric precursor B acute lymphoblastic leukemias in India. Int. J. Oncol. 13:1319–1322.PubMedGoogle Scholar
  67. 67.
    Scheinberg, D. A., Maslak, P. and Weiss, M. (2001). Acute leukemias, in Cancer Principles and Practice of Oncology, 6th ed. (Devita, V. T., Hellman, S. and Rosenberg, S. A., eds.) Lippincott William & Wilkins, Philadelphia.Google Scholar
  68. 68.
    Raina, V. and Kochupillai, V. (1983). Acute myeloid leukemia in adults: experience at AIIMS. J. Assoc. Physicians India 31(8):511–514.PubMedGoogle Scholar
  69. 69.
    Advani, S. H., Rao, D. N., Kutty, P. M., Gopal, R. and Nair, C. N. (1983). Acute non-lymphoblastic leukemia in Indian populations/ FAB classification and response to therapy. Indian J. Cancer 20:131–136.PubMedGoogle Scholar
  70. 70.
    Kasthuri, A. S., Jaiprakash, M. P., Panicker, N. K., Gupta, M. M., Rajoor, G. S., Basu, S. K., et al. (1988). A clinical study of adult leukemias. J Assoc Physicians India 38(6):403–407.Google Scholar
  71. 71.
    Morrison, V. A. (1994). Chronic leukemias. CA Cancer J. Clin. 44:353.PubMedCrossRefGoogle Scholar
  72. 72.
    Kumar, L., Sagar, T. G., Maitreyan, V., Majhi, U. and Shanta, V. (1990). Chronic granulocytic leukemia. A study of 160 cases. J. Assoc. Physicians India 38(12):899–902.PubMedGoogle Scholar
  73. 73.
    Prabhu, M., Kochupillai, V., Sharma, S., Ramachandram, P., Sundaram, K. R., Bijlani, L., et al. (1986). Prognostic assessment of various parameters in chronic myeloid leukemia. Cancer 58:1357–1360.PubMedCrossRefGoogle Scholar
  74. 74.
    Bhaduri, S., Gupta, R. C., Chawla, S. P. and Manglik, A. (1979). Chronic granulocytic leukemia. A study of 177 cases. Indian J. Cancer 16:1–7.PubMedGoogle Scholar
  75. 75.
    Wells, R. and Lau, K. S. (1960). Incidence of leukemia in Singapore and rarity of CLL in Chinese. Br. Med. J. 1:759.PubMedGoogle Scholar
  76. 76.
    Rosenthal, N. and Harris, W. (1935). Leukemia—its diagnosis and treatment. J. Am. Med. Assoc. 104:702.Google Scholar
  77. 77.
    Yong, A. and Goldman, J. M. (2000). Chronic myeloid leukemia, in Clinical Oncology 2nd ed. (Abeloff, M. D., Armitage, J. O., Lichter, A. S. and Niederhubes, J. E., eds.), pp 2579–2596, Churchill Livingstone, Philadelphia.Google Scholar
  78. 78.
    Kadam, P. R., Najangud, G. J., Advani, S. H., Nair, C., Banavali, S., Gopal, R., et al. (1991). Chromosomal characteristics of chronic and blastic phase of chronic myeloid leukemia—study of 100 patients in India. Cancer Genet. Cytogenet. 51:167–181.PubMedCrossRefGoogle Scholar
  79. 79.
    Nair, C. N., Chougule, A., Dhond, S., Goyal, R., Parikh, P. M., Pai, S., et al. (1998). Trisomy 12 in chronic lymphocytic leukemia—geographical variation. Leukemia Res. 22:313–317.CrossRefGoogle Scholar
  80. 80.
    Montserrat, E. and Rozman, C. (1995). Chronic lymphocytic leukemia: present status. Ann. Oncol. 6:219–235.PubMedGoogle Scholar
  81. 81.
    Parikh, P. M., Desai, S., Naresh, K. W., Shakuntaka, B., Laxminarayan, K., Nair, C. N., et al. (1996). Incidence of 5 bcl-2 rearrangement in patients with B cell chronic lymphocytic leukemia from India. Leukemia Res. 20(9):791–793.CrossRefGoogle Scholar

Copyright information

© Humana Press Inc 2002

Authors and Affiliations

  • Manisha Bhutani
    • 1
  • Amish Vora
    • 1
  • Lalit Kumar
    • 1
  • Vinod Kochupillai
    • 1
    Email author
  1. 1.Department of Medical OncologyInstitute Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations