scholarly journals Association between multimorbidity and socioeconomic deprivation on short-term mortality among patients with diffuse large B-cell or follicular lymphoma in England: a nationwide cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049087
Author(s):  
Matthew James Smith ◽  
Edmund Njeru Njagi ◽  
Aurelien Belot ◽  
Clémence Leyrat ◽  
Audrey Bonaventure ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
B Cell ◽  
Mortality Risk ◽  
Population Based ◽  
Socioeconomic Deprivation ◽  
Short Term ◽  
English Population ◽  
Short Term Mortality ◽  
Rate Ratios ◽  
Large B Cell

ObjectivesWe aimed to assess the association between multimorbidity and deprivation on short-term mortality among patients with diffuse large B-cell (DLBCL) and follicular lymphoma (FL) in England.SettingThe association of multimorbidity and socioeconomic deprivation on survival among patients diagnosed with DLBCL and FL in England between 2005 and 2013. We linked the English population-based cancer registry with electronic health records databases and estimated adjusted mortality rate ratios by multimorbidity and deprivation status. Using flexible hazard-based regression models, we computed DLBCL and FL standardised mortality risk by deprivation and multimorbidity at 1 year.ResultsOverall, 41 422 patients aged 45–99 years were diagnosed with DLBCL or FL in England during 2005–2015. Most deprived patients with FL with multimorbidities had three times higher hazard of 1-year mortality (HR: 3.3, CI 2.48 to 4.28, p<0.001) than least deprived patients without comorbidity; among DLBCL, there was approximately twice the hazard (HR: 1.9, CI 1.70 to 2.07, p<0.001).ConclusionsMultimorbidity, deprivation and their combination are strong and independent predictors of an increased short-term mortality risk among patients with DLBCL and FL in England. Public health measures targeting the reduction of multimorbidity among most deprived patients with DLBCL and FL are needed to reduce the short-term mortality gap.

scholarly journals Excess Mortality by Multimorbidity, Socioeconomic, and Healthcare Factors, amongst Patients Diagnosed with Diffuse Large B-Cell or Follicular Lymphoma in England

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5805
Author(s):  
Matthew James Smith ◽  
Aurélien Belot ◽  
Matteo Quartagno ◽  
Miguel Angel Luque Fernandez ◽  
Audrey Bonaventure ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
B Cell ◽  
Excess Mortality ◽  
Population Based ◽  
Cancer Registry Data ◽  
Mortality Hazard ◽  
Comorbidity Status ◽  
Imputation Approach ◽  
Large B Cell ◽  
Deprived Areas

(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients’ comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics. We used a flexible multilevel excess hazard model to estimate excess mortality and net survival by patient’s comorbidity status, adjusted for sociodemographic, economic, and healthcare factors, and accounting for the patient’s area of residence. We used the latent normal joint modelling multiple imputation approach for missing data. (3) Results: Overall, 15,516 and 29,898 patients were diagnosed with FL and DLBCL in England between 2005 and 2013, respectively. Amongst DLBCL and FL patients, respectively, those in the most deprived areas showed 1.22 (95% confidence interval (CI): 1.18–1.27) and 1.45 (95% CI: 1.30–1.62) times higher excess mortality hazard compared to those in the least deprived areas, adjusted for comorbidity status, age at diagnosis, sex, ethnicity, and route to diagnosis. (4) Conclusions: Deprivation is consistently associated with poorer survival among patients diagnosed with DLBCL or FL, after adjusting for co/multimorbidities. Comorbidities and multimorbidities need to be considered when planning public health interventions targeting haematological malignancies in England.

Rituximab use and survival after diffuse large B-cell or follicular lymphoma: a population-based study

2012 ◽  
Vol 54 (4) ◽  
pp. 743-751 ◽  
Author(s):  
Theresa H. M. Keegan ◽  
Lisa M. Moy ◽  
James M. Foran ◽  
Ash A. Alizadeh ◽  
Ellen T. Chang ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
B Cell ◽  
Population Based ◽  
Population Based Study ◽  
Large B Cell

scholarly journals The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maja Niksic ◽  
Daniel Redondo-Sanchez ◽  
Yoe-Ling Chang ◽  
Miguel Rodriguez-Barranco ◽  
Jose Exposito-Hernandez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Lung Cancer ◽  
Cancer Patients ◽  
Mortality Risk ◽  
Lung Cancer Mortality ◽  
Population Based ◽  
Short Term ◽  
Lung Cancer Patients ◽  
Short Term Mortality ◽  
After Cancer

Abstract Aim Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims to describe the prevalence and patterns of having one (comorbidity) or ≥ 2 chronic diseases (multimorbidity) among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and short-term mortality risk at six months after cancer diagnosis. Methods In this population-based cohort study, data were drawn from two Spanish population-based cancer registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients, diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex, smoking status, province of residence, surgery, cancer stage, histology, and body mass index. Results We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men, those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities were chronic obstructive pulmonary disease (36.6%), diabetes (20.7%) and heart failure (16.8%). The strongest pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40% higher overall mortality risk than those without comorbidities (aHR for comorbidity: 1.4, 95%CI: 1.1–1.7; aHR for multimorbidity: 1.4, 95%CI: 1.1–1.8), when relevant confounding factors were considered. Conclusions The presence of comorbid diseases, rather than the number of comorbidities, was associated with increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients with one or more comorbidities in Spain.

scholarly journals Incidence of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) including CNS relapse in a population-based cohort of 4243 patients in Sweden

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sara Harrysson ◽  
Sandra Eloranta ◽  
Sara Ekberg ◽  
Gunilla Enblad ◽  
Mats Jerkeman ◽  
...  
Keyword(s):  
B Cell ◽  
Cumulative Incidence ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Refractory Disease ◽  
Curative Intent ◽  
Large B Cell Lymphoma ◽  
Cns Relapse ◽  
Large B Cell

AbstractWe performed a national population-based study of all patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in Sweden in 2007–2014 to assess treatment intent and risk of relapsed/refractory disease, including central nervous system (CNS) relapse, in the presence of competing risks. Overall, 84% of patients started treatment with curative intent (anthracycline-based) (n = 3550, median age 69 years), whereas 14% did not (n = 594, median age 84 years) (for 2% the intent was uncertain). Patients treated with curative intent had a 5-year OS of 65.3% (95% CI: 63.7–66.9). The median OS among non-curatively treated patients was 2.9 months. The 5-year cumulative incidence of relapsed/refractory disease in curative patients was 23.1% (95% CI: 21.7–24.6, n = 847). The 2-year cumulative incidence of CNS relapse was 3.0% (95% CI: 2.5–3.6, n = 118) overall, and 8.0% (95% CI: 6.0–10.6, n = 48) among patients with high CNS-IPI (4–6), when considering other relapse locations and death as competing events. The incidence of relapsed/refractory DLBCL overall and in the CNS was lower than in previous reports, still one in seven patients was not considered fit enough to start standard immunochemotherapy at diagnosis. These results are important for quantification of groups of DLBCL patients with poor prognosis requiring completely different types of interventions.

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