Joint analysis of 1695 cases of malignant lymphoma from the ukranian and cluj napoca lymphoma registries

Abstract

Background: Lymphomas represent a diverse group of hematologic malignancies with substantial regional variations in incidence, histological subtypes, and disease presentation. Cancer registries serve as essential tools for understanding epidemiological trends, guiding clinical decision‐making, and improving patient outcomes. This study integrates data from the Ukrainian and Cluj Napoca Lymphoma registries to analyze demographic characteristics, histological distribution, and disease presentation across different populations. Aim: The objective of this study was to perform a comparative analysis of malignant lymphoma cases across different regions, identifying trends in histopathology, disease stage, biological markers, and clinical features. Methods: Data from 1695 lymphoma cases were analyzed: 1137 (67.08%) from the NCI, 343 (20.24%) from other Ukrainian regions, and 215 (12.68%) from Romania. Comparative statistical analysis of disease subtypes, staging, biological markers, and clinical features was conducted using ANOVA and the Kruskal‐Wallis H‐test. Results: Mature B‐cell neoplasms constituted the majority of cases (71.21%), with significant differences across cohorts. Chronic lymphocytic leukemia (CLL) was more prevalent in non‐NCI Ukrainian regions (22.16%) and Romania (21.40%) compared to the NCI (7.48%) (p < 0.005), reflecting regional differences in referral patterns. Diffuse large B‐cell lymphoma (DLBCL) represented 23.37% of cases overall, with a higher proportion in non‐NCI Ukrainian cases (26.24%) compared to NCI (22.93%) and Romania (20.93%). Primary mediastinal large B‐cell lymphoma (PMBCL) was significantly more common in the NCI cohort (10.5%) compared to non‐NCI Ukrainian cases (2.9%) and Romanian cases (2.4%) (p < 0.005), similarly, primary CNS lymphoma was observed exclusively in the NCI cohort (8.6%), with no cases reported from regional Ukrainian or Romanian registries, this discrepancy can be explained by the fact that NCI functions as a reference center, receiving patients from across Ukraine. Advanced‐stage disease (Stage III‐IV) was more prevalent in non‐NCI Ukrainian cases (71.14%) than in Romanian (55.35%) and NCI patients (55.45%) (p < 0.005). Bone marrow involvement was detected in 13.22% of cases, with higher rates in non‐ NCI Ukrainian regions (16.62%) compared to NCI (12.66%) and Romanian cases (10.7%). Extranodal involvement was significantly more common at the NCI (49.34%) than in non‐NCI Ukrainian cases (37.32%) and Romanian cases (25.58%) (p< 0.005).