scholarly journals Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study

2021 ◽  
Vol 11 (12) ◽  
Author(s):  
Ilja Kalashnikov ◽  
Tomas Tanskanen ◽  
Janne Pitkäniemi ◽  
Nea Malila ◽  
Sirkku Jyrkkiö ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Relative Survival ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Population Based Study ◽  
Entire Study ◽  
Risk Of Death ◽  
Increased Risk ◽  
Histological Transformation

AbstractNodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare B-cell malignancy associated with excellent survival. However, some patients experience histological transformation into aggressive large B-cell lymphoma. Population-based data on transformation in patients with NLPHL is limited. We conducted a nationwide population-based study to estimate the risk of transformation and relative survival in patients diagnosed with NLPHL in Finland between 1995 and 2018. We identified a total of 453 patients (median age, 48 years; 76% males) with the incident NLPHL from the Finnish Cancer Registry. The cumulative incidence of transformation was 6.3% (95% CI, 4.2-9.6) at 10 years. After adjusting for sex, age and year of diagnosis, transformation was associated with a substantially increased risk of death (HR 8.55, 95% CI 4.49−16.3). Ten-year relative survival was 94% (95% CI, 89%‒100%). The patients diagnosed at a later calendar year had lower excess risk of death (HR, 0.38 per 10-year increase; 95% CI, 0.15‒0.98). We conclude that while the 10-year relative survival for the patients with NLPHL was excellent in this large population-based cohort for the entire study period, transformation resulted in a substantially increased mortality compared with the patients without transformation. Our results also suggest a reduction in excess mortality over time.

scholarly journals Accuracy of Pathologic Diagnosis in Patients With Lymphoma and Survival: A Prospective Analysis From Botswana

2021 ◽  
pp. 1620-1632
Author(s):  
Fallon E. Chipidza ◽  
Mukendi K. A. Kayembe ◽  
Isaac Nkele ◽  
Jason A. Efstathiou ◽  
Bruce A. Chabner ◽  
...  
Keyword(s):  
Overall Survival ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Diagnostic Techniques ◽  
African Countries ◽  
Risk Of Death ◽  
Pathologic Diagnosis ◽  
Increased Risk ◽  
Discordant Diagnosis

PURPOSE With intense HIV epidemics, southern African countries have a high burden of classic Hodgkin lymphoma (CHL) and non-Hodgkin lymphoma (NHL). However, suboptimal access to pathology resources limits subtype classification. We sought to assess the diagnostic accuracy of specimens classified as lymphoma and to determine association between discordant pathologic diagnosis and overall survival. METHODS Seventy patients with CHL or NHL and treated at three Botswana hospitals from 2010 to 2016 were analyzed. Local pathologic assessment relied primarily on morphology. All cases underwent secondary US hematopathology review, which is considered gold standard. RESULTS The median follow-up was 58 months. The overall reclassification rate was 20 of 70 cases (29%). All 20 CHL cases were correctly classified in Botswana, and mixed cellularity was the most common subtype, diagnosed in 11 (55%) cases. Of 47 confirmed NHL cases, diffuse large B-cell lymphoma was the final US diagnosis in 28 cases (60%), another aggressive B-cell NHL in nine (19%), an indolent B-cell NHL in six (13%), and T-cell NHL in four (9%). Common types of diagnostic discordance included NHL subtype reclassification (11 of 20, 55%) and CHL reclassified as NHL (7 of 20, 35%). Concordant versus discordant diagnosis after secondary review was associated with improved 5-year overall survival (60.1% v 26.3%, P = .0066). Discordant diagnosis was independently associated with increased risk of death (adjusted hazard ratio 2.733; 95% CI, 1.102 to 6.775; P = .0300) even after stratifying results by CHL versus NHL. CONCLUSION In this single prospective cohort, discordant pathologic diagnosis was associated with a nearly three-fold increased risk of death. Limited access to relatively basic diagnostic techniques impairs treatment decisions and leads to poor patient outcomes in low-resource countries.

scholarly journals Treatment intensity and survival in patients with relapsed or refractory diffuse large B-cell lymphoma in Denmark: a real-life population-based study

2019 ◽  
Vol Volume 11 ◽  
pp. 207-216 ◽  
Author(s):  
Bente Arboe ◽  
Maja Halgren Olsen ◽  
Jette Sønderskov Gørløv ◽  
Anne Katrine Duun-Henriksen ◽  
Susanne Oksbjerg Dalton ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Real Life ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Treatment Intensity ◽  
Population Based Study ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Comparison of outcomes among patients aged 80 and over and younger patients with diffuse large B-cell lymphoma: a population based study

2013 ◽  
Vol 55 (3) ◽  
pp. 533-537 ◽  
Author(s):  
Cindy Varga ◽  
Christina Holcroft ◽  
Abbas Kezouh ◽  
Serghei Bucatel ◽  
Nathalie Johnson ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Population Based ◽  
80 And Over ◽  
Aged 80 And Over ◽  
Population Based Study ◽  
Younger Patients ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Trends in Overall Survival and Treatment Patterns in Two Large Population-Based Cohorts of Patients with Breast and Colorectal Cancer

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1239 ◽  
Author(s):  
Abbema ◽  
Vissers ◽  
Vos-Geelen ◽  
Lemmens ◽  
Janssen-Heijnen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Treatment Patterns ◽  
Entire Study ◽  
Younger Patients ◽  
Risk Of Death ◽  
Over Time

Previous studies showed substantial improvement of survival rates in patients with cancer in the last two decades. However, lower survival rates have been reported for older patients compared to younger patients. In this population-based study, we analyzed treatment patterns and the survival of patients with breast cancer (BC) and colorectal cancer (CRC). Patients with stages I–III BC and CRC and diagnosed between 2003 and 2012 were selected from the Netherlands Cancer Registry (NCR). Trends in treatment modalities were evaluated with the Cochran-Armitage trend test. Trends in five-year overall survival were calculated with the Cox hazard regression model. The Ederer II method was used to calculate the five-year relative survival. The relative excess risk of death (RER) was estimated using a multivariate generalized linear model. During the study period, 98% of BC patients aged <75 years underwent surgery, whereas for patients ≥75 years, rates were 79.3% in 2003 and 66.7% in 2012 (p < 0.001). Most CRC patients underwent surgery irrespective of age or time period, although patients with rectal cancer aged ≥75 years received less surgery or radiotherapy over the entire study period than younger patients. The administration of adjuvant chemotherapy increased over time for CRC and BC patients, except for BC patients aged ≥75 years. The five-year relative survival improved only in younger BC patients (adjusted RER 0.95–0.96 per year), and was lower for older BC patients (adjusted RER 1.00, 95% Confidence Interval (CI) 0.98–1.02, and RER 1.00; 95% CI 0.98–1.01 per year for 65–74 years and ≥75 years, respectively). For CRC patients, the five-year relative survival improved over time for all ages (adjusted RER on average was 0.95 per year). In conclusion, the observed survival trends in BC and CRC patients suggest advances in cancer treatment, but with striking differences in survival between older and younger patients, particularly for BC patients.

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Blood ◽  
2012 ◽  
Vol 119 (4) ◽  
pp. 990-996 ◽  
Author(s):  
Jan Sjöberg ◽  
Cat Halthur ◽  
Sigurdur Y. Kristinsson ◽  
Ola Landgren ◽  
Ulla Axdorph Nygell ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Age Groups ◽  
Relative Survival ◽  
Population Based ◽  
Term Treatment ◽  
Cure Rate ◽  
Population Based Study ◽  
Long Term Treatment

Abstract In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N = 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009). Relative survival improved in all age groups, with the greatest improvement in patients 51-65 years of age (P < .0005). A plateau in relative survival was observed in patients below 65 years of age during the last calendar period, suggesting a reduced long-term, treatment-related mortality. The 10-year relative survival for patients diagnosed in 2000-2009 was 0.95, 0.96, 0.93, 0.80, and 0.44 for the age groups 0-18, 19-35, 36-50, 51-65, and 66-80, respectively. Therefore, despite progress, age at diagnosis remains an important prognostic factor (P < .0005). Advances in therapy for patients with limited and advanced-stage HL have contributed to an increasing cure rate. In addition, our findings support that long-term mortality of HL therapy has decreased. Elderly HL patients still do poorly, and targeted treatment options associated with fewer side effects will advance the clinical HL field.

Patterns of Care in a Random Population-Based Sample of Patients Diagnosed with Non-Hodgkin’s Lymphoma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 85-85 ◽  
Author(s):  
Dierdre P. Cronin ◽  
Linda C. Harlan ◽  
Limin X. Clegg ◽  
Jennifer L. Stevens ◽  
Gigi Yuan ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
T Cell ◽  
B Cell ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Histological Subtypes ◽  
Population Based Study ◽  
Factors Associated ◽  
Risk Of Death ◽  
The Impact

Abstract The advent of therapeutic monoclonal antibodies has enhanced the efficacy of NHL treatment. In recent years, these immuno-therapies have been increasingly used in therapy. We conducted a population-based study of NHL treatment practices in the US using a stratified random sample of patients diagnosed in 1999 with histologically confirmed NHL (n=939) residing in the geographic areas covered by the Surveillance, Epidemiology and End Results program. Blacks and Hispanics were over-sampled to obtain more stable estimates. Patients were followed for vital status through Dec 2001. We performed separate logistic regression analyses to study the potential factors associated with the likelihood of receiving chemotherapy, radiation therapy and the monoclonal antibody, Rituximab. Cox Proportional Hazards regression model was used to study the risk factors associated with survival time. We grouped histological subtypes into five broad categories: B-cell aggressive, B-cell indolent, T-cell generic, cutaneous T-cell, and mantle cell lymphomas. The majority of patients presented with B-cell aggressive or B-cell indolent lymphomas (n=828). Approximately 20% of patients received no therapy. Over 60% of patients received chemotherapy, either alone or in combination. 12% of patients received Rituximab and it was most frequently administered to patients in combination with chemotherapy, especially for patients with B-cell aggressive, B-cell indolent and T-cell generic lymphomas. Only 3% of patients participated in clinical trials. Age and gender were associated with the receipt of chemotherapy: people aged over 75 years, and males were less likely to have received chemotherapy (P=0.01). There were no significant associations between the likelihood of receiving Rituximab and the demographic and clinical factors analyzed. However, our results suggested that African-Americans and people aged over 75 years were less likely to have received immunotherapy. Twenty-four percent of patients received radiation with or without another therapy. When compared to patients with no symptoms at presentation, patients who presented with B-symptoms at diagnosis or those whose B-symptoms were unknown were less likely to have received radiation therapy (OR=0.32 and 0.47 respectively, P=0.0002). Approximately 50% of patients had died by the end of maximum the 3-year follow-up period. Both cause-specific and all-cause mortality was significantly associated with patient age, race/ethnicity, gender, marital status and co-morbid conditions, as well as histological subgroup. Hispanic and Black patients had higher risk of death from both NHL and all-cause (P<0.01) than their non-Hispanic white counterparts. Patients > 75 years, male patients, unmarried patients, or patients with B-symptoms had higher risk of death from either NHL or all-cause (p<0.01). This paper is the first population-based study examining the receipt of therapy for many histological subtypes of NHL. Future work will examine the impact of treatment on survival.

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