Plasmablastic lymphoma (PBL) remains one of the most aggressive and least understood subtypes of non-Hodgkin lymphoma, particularly in regions with high HIV prevalence. Despite its severity, data from sub-Saharan Africa have been limited, constraining clinicians and policymakers in developing effective strategies for early detection and treatment.
At the First Annual Public Health Institute of Malawi Research Conference (October 29–31, Lilongwe), Dr. Edwards Kasonkanji—clinician and UNC Cancer Program Team Lead for the Adult Oncology Clinic—presented findings from a landmark study titled “Clinical Characteristics and Outcomes of Plasmablastic Lymphoma in Malawi: A Prospective Cohort Study.”
The study, conducted under the LCCC1229 lymphoma cohort at Kamuzu Central Hospital Cancer Centre, reviewed all histologically confirmed PBL cases diagnosed between 2014 and 2024. This dataset, encompassing 33 patients, is among the few long-term analyses of PBL in a low-resource African setting.
Key Findings Include:
- HIV Association: Over half of patients (56%) were HIV-positive and on ART prior to diagnosis, reaffirming the strong link between PBL and HIV.
- Disease Presentation: Although 73% presented with early-stage disease, more than one-third had poor performance status, indicating advanced illness at presentation.
- Survival Outcomes: Prognosis was uniformly poor—73% of patients died during follow-up, with a median overall survival of just 10 months. HIV status did not significantly affect outcomes.
These results underscore the urgent need for earlier detection, integrated HIV and cancer care, and improved access to advanced therapies. PBL remains a formidable challenge in Malawi, driven by its HIV association, late-stage presentation, limited diagnostic capacity, and restricted treatment options.