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Su H, Xie S, Lyu J, Liu Y, Zhang Y. Secular trends in incidence and mortality of non-Hodgkin's lymphoma in China, 1990-2019, and predictions to 2030: Outlook for the future burden of disease. TUMORI JOURNAL 2024:3008916241261166. [PMID: 39096014 DOI: 10.1177/03008916241261166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND The aim of this study was to analyze the trend of non-Hodgkin's lymphoma incidence and mortality in China from 1990 to 2019, along with assessing the effects of age, period, and cohort, as well as to predict future trends. MATERIAL AND METHODS Using data from the Global Burden of Disease Study 2019 we calculated the estimated annual percentage changes in the incidence and mortality of non-Hodgkin's lymphoma. Age-period-cohort analysis was used to assess the independent effects of these elements. Incidence and mortality until 2030 were predicted using a Bayesian age-period-cohort approach. RESULTS During 1990-2019, there was a significant increase in the age-standardized incidence and mortality rate in non-Hodgkin's lymphoma. Strong effects of birth cohort and period on non-Hodgkin's lymphoma incidence and mortality were observed. In terms of prediction, future non-Hodgkin's lymphoma incidence and mortality in China will continue to increase, while the mortality rate will decrease; for women, both the rates are projected to rise, but they will remain lower than men. CONCLUSIONS Currently, the non-Hodgkin's lymphoma burden is high in China, and it is expected to continue increasing in the future. Policymakers need to prioritize addressing the factors contributing to sex differences in disease burden, including variations in environmental exposures and lifestyles among men and women.
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Affiliation(s)
- Hongbo Su
- School of Physical Education, Shanxi University, No. 92, Wucheng Road, Taiyuan 030006, China
- Department of Breast Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China
- Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Shuping Xie
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, Guangdong, China
| | - Yan Liu
- Department of Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yanbo Zhang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
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Papaleo N, Climent F, Tapia G, Luizaga L, Azcarate J, Bosch-Schips J, Muñoz-Marmol AM, Salido M, Lome-Maldonado C, Vazquez I, Colomo L. Round-robin testing for LMO2 and MYC as immunohistochemical markers to screen MYC rearrangements in aggressive large B-cell lymphoma. Virchows Arch 2024; 485:307-314. [PMID: 37368083 PMCID: PMC11329383 DOI: 10.1007/s00428-023-03584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/25/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023]
Abstract
Aggressive large B-cell lymphomas (aLBCL) include a heterogeneous group of lymphomas with diverse biological features. One of the approaches to the diagnosis of aLBCL is based on the identification of MYC rearrangements (MYC-R), in addition to BCL2 and BCL6 rearrangements by genetic techniques, mainly fluorescent in situ hybridization (FISH). Because of the low incidence of MYC-R, the identification of useful immunohistochemistry markers to select cases for MYC FISH testing may be useful in daily practice. In a previous work, we identified a strong association between the profile CD10 positive/LMO2 negative expression and the presence of MYC-R in aLBCL and obtained good intralaboratory reproducibility. In this study, we wanted to evaluate external reproducibility. To evaluate whether LMO2 can be a reproducible marker between observers 50 aLBCL cases were circulated among 7 hematopathologists of 5 hospitals. Fleiss' kappa index for LMO2 and MYC were 0.87 and 0.70, respectively, indicating high agreement between observers. In addition, during 2021-2022, the enrolled centers included LMO2 in their diagnostic panels to evaluate prospectively the utility of the marker, and 213 cases were analyzed. Comparing LMO2 with MYC, the group of CD10 positive cases showed higher specificity (86% vs 79%), positive predictive value (66% vs 58%), likelihood positive value (5.47 vs 3.78), and accuracy (83% vs 79%), whereas the negative predictive values remained similar (90% vs 91%). These findings place LMO2 as a useful and reproducible marker to screen MYC-R in aLBCL.
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MESH Headings
- Humans
- LIM Domain Proteins/genetics
- LIM Domain Proteins/metabolism
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Proto-Oncogene Proteins c-myc/genetics
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Adaptor Proteins, Signal Transducing/analysis
- Immunohistochemistry
- Gene Rearrangement
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Proto-Oncogene Proteins/genetics
- Reproducibility of Results
- Male
- Female
- Middle Aged
- Aged
- In Situ Hybridization, Fluorescence
- Predictive Value of Tests
- Adult
- Prospective Studies
- Aged, 80 and over
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Affiliation(s)
- Natalia Papaleo
- Department of Pathology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Fina Climent
- Department of Pathology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Gustavo Tapia
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Department of Pathology, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - Luis Luizaga
- Department of Pathology, Hospital Mutua Terrassa, Terrassa, Barcelona, Spain
| | - Juan Azcarate
- Department of Pathology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jan Bosch-Schips
- Department of Pathology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ana M Muñoz-Marmol
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Department of Pathology, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - Marta Salido
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Carmen Lome-Maldonado
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Ivonne Vazquez
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Luis Colomo
- Universitat Pompeu Fabra, Barcelona, Spain.
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain.
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Kuruvilla J, Ewara EM, Elia-Pacitti J, Ng R, Eberg M, Kukaswadia A, Sharma A. Estimating the Burden of Illness of Relapsed Follicular Lymphoma and Marginal Zone Lymphoma in Ontario, Canada. Curr Oncol 2023; 30:4663-4676. [PMID: 37232810 DOI: 10.3390/curroncol30050352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Many patients with advanced follicular lymphoma (FL) and marginal zone lymphoma (MZL) relapse after first-line chemotherapy. OBJECTIVE To examine healthcare resource utilization (HCRU) and cost, treatment patterns, progression, and survival of patients with FL and MZL who relapse after first-line treatment, in Ontario, Canada. METHODS A retrospective, administrative data study identified patients with relapsed FL and MZL (1 January 2005-31 December 2018). Patients were followed for up to three years post relapse to assess HCRU, healthcare costs, time to next treatment (TTNT), and overall survival (OS), stratified by first- and second-line treatment. RESULTS The study identified 285 FL and 68 MZL cases who relapsed after first-line treatment. Average duration of first-line treatment was 12.4 and 13.4 months for FL and MZL patients, respectively. Drug (35.9%) and cancer clinic costs (28.1%) were major contributors to higher costs in year 1. Three-year OS was 83.9% after FL and 74.2% after MZL relapse. No statistically significant differences were observed in TTNT and OS between patients with FL who received R-CHOP/R-CVP/BR in the first line only versus both the first- and second- line. A total of 31% of FL and 34% of MZL patients progressed to third-line treatment within three years of initial relapse. CONCLUSION Relapsing and remitting nature of FL and MZL in a subset of patients results in substantial burden to patients and the healthcare system.
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Affiliation(s)
- John Kuruvilla
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON M5G 2C1, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 3H7, Canada
| | - Emmanuel M Ewara
- Market Access, Janssen Canada Inc., 19 Green Belt Drive, North York, ON M3C 1L9, Canada
| | - Julia Elia-Pacitti
- Medical Affairs, Janssen Canada Inc., 19 Green Belt Drive, North York, ON M3C 1L9, Canada
| | - Ryan Ng
- Real World Solutions, IQVIA, 16720 Rte Transcanadienne, Kirkland, QC H9H 5M3, Canada
| | - Maria Eberg
- Real World Solutions, IQVIA, 16720 Rte Transcanadienne, Kirkland, QC H9H 5M3, Canada
| | - Atif Kukaswadia
- Real World Solutions, IQVIA, 300-6700 Century Avenue, Mississauga, ON L5N 6A4, Canada
| | - Arushi Sharma
- Real World Solutions, IQVIA, 535 Legget Drive, Tower C, 7th Floor, Ottawa, ON K2K 3B8, Canada
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Gao H, Wang X, Lai Y, Zhang C, Mi L, Ji X, Wang X, Song Y, Zhu J, Liu W. Different situations of identifying second primary malignant tumors in lymphoma patients with synchronous solid tumors. Cancer Med 2023; 12:8038-8049. [PMID: 36621802 PMCID: PMC10134266 DOI: 10.1002/cam4.5592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/20/2022] [Accepted: 12/22/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To our knowledge, the different situations of identifying second primary malignant tumors (SPMTs) in lymphoma patients with synchronous solid tumors remain to be comprehensively investigated. METHODS We retrospectively collected information pertaining to lymphoma patients with synchronous solid tumors (diagnosed within 6 months) at Peking University Cancer Hospital & Institute between 2009 and 2019. The non-parametric Aalen-Johansen estimator was applied to calculate cumulative incidence function in the competing risk model. Furthermore, propensity score-matched analysis was performed to compare survival differences in lymphoma patients with or without synchronous solid tumors. RESULTS Thirty-eight patients were enrolled. There were three situations of identifying SPMTs. First, in 15 patients (39.5%), SPMTs were identified before the initiation of any treatment. Among them, priority was given to anti-lymphoma treatment in case of only three patients. Second, in 17 patients (44.7%), SPMTs were unexpectedly detected on surgical specimen assessment; of them, 13 received anti-lymphoma treatment after surgery. Third, in six patients (15.8%), SPMTs were identified after the outset of treatment for the primary tumor; in this population, three of four patients with lymphoma switched toward the treatment plan for SPMTs. The 5-year overall survival was 58.7%. The cumulative incidence function within 5 years was 26.6% for lymphoma and 14.7% for other solid tumors. The early identification of SPMTs was associated with better outcomes (p = 0.048). After balancing the baseline characteristics, no differences in survival were observed between lymphoma patients with and without synchronous solid tumors (p = 0.664). CONCLUSIONS This is the first study to present the different situations of identifying SPMTs in lymphoma patients with synchronous solid tumors. In only <50% patients, SPMTs were identifiable at baseline. SPMT identification at different situations may make it difficult to choose the optimal therapeutic option, which may consequently impact patient survival.
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Affiliation(s)
- Hongye Gao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaogan Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yumei Lai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Chen Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lan Mi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xinqiang Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Medical Record Statistics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaopei Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yuqin Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jun Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Weiping Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
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Bezawork-Geleta A, Dimou J, Watt MJ. Lipid droplets and ferroptosis as new players in brain cancer glioblastoma progression and therapeutic resistance. Front Oncol 2022; 12:1085034. [PMID: 36591531 PMCID: PMC9797845 DOI: 10.3389/fonc.2022.1085034] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
A primary brain tumor glioblastoma is the most lethal of all cancers and remains an extremely challenging disease. Apparent oncogenic signaling in glioblastoma is genetically complex and raised at any stage of the disease's progression. Many clinical trials have shown that anticancer drugs for any specific oncogene aberrantly expressed in glioblastoma show very limited activity. Recent discoveries have highlighted that alterations in tumor metabolism also contribute to disease progression and resistance to current therapeutics for glioblastoma, implicating an alternative avenue to improve outcomes in glioblastoma patients. The roles of glucose, glutamine and tryptophan metabolism in glioblastoma pathogenesis have previously been described. This article provides an overview of the metabolic network and regulatory changes associated with lipid droplets that suppress ferroptosis. Ferroptosis is a newly discovered type of nonapoptotic programmed cell death induced by excessive lipid peroxidation. Although few studies have focused on potential correlations between tumor progression and lipid droplet abundance, there has recently been increasing interest in identifying key players in lipid droplet biology that suppress ferroptosis and whether these dependencies can be effectively exploited in cancer treatment. This article discusses how lipid droplet metabolism, including lipid synthesis, storage, and use modulates ferroptosis sensitivity or tolerance in different cancer models, focusing on glioblastoma.
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Affiliation(s)
- Ayenachew Bezawork-Geleta
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, VIC, Australia,*Correspondence: Ayenachew Bezawork-Geleta,
| | - James Dimou
- Department of Surgery, The University of Melbourne, Parkville, VIC, Australia,Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Matthew J. Watt
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Xie S, Yu Z, Feng A, Zheng S, Li Y, Zeng Y, Lyu J. Analysis and prediction of relative survival trends in patients with non-Hodgkin lymphoma in the United States using a model-based period analysis method. Front Oncol 2022; 12:942122. [PMID: 36237337 PMCID: PMC9551310 DOI: 10.3389/fonc.2022.942122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Survival rates are usually used to evaluate the effect of cancer treatment and prevention. This study aims to analyze the 5-year relative survival of non-Hodgkin lymphoma (NHL) in United States using population-based cancer registry data. Methods A period analysis was used to evaluate the improvement in long-term prognosis of patients with NHL from 2004 to 2018, and a generalized linear model was developed to predict the 5-year relative survival rates of patients during 2019–2023 based on data from the SEER database stratified by age, sex, race and subtype. Results In this study, relative survival improved for all NHL, although the extent of improvement varied by sex, age group and lymphoma subtype. Survival improvement was also noted for NHL subtypes, although the extent varied, with marginal-zone lymphoma having the highest 5-year relative survival rate (92.5%) followed by follicular lymphoma (91.6%) and chronic lymphocytic leukemia/small lymphocytic lymphoma (87.3%). Across all subtypes, survival rates were slightly higher in females than in males. Survival rates are lower in the elderly than in the young. Furthermore, the study demonstrated that black patients had lower NHL survival rates than white patients. Survival rates for NHL were higher in rural areas than in urban areas. Patients with extra-nodal NHL had a higher survival rate than patients with nodal NHL. Conclusion Overall, patient survival rates for NHL gradually improved during 2004–2018. The trend continues with a survival rate of 75.2% for the period 2019–2023. Analysis by NHL subtype and subgroups indicating that etiology and risk factors may differ by subtype. Identification of population-specific prevention strategies and treatments for each subtype can be aided by understanding these variations.
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Affiliation(s)
- Shuping Xie
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Zhong Yu
- School of Public Health, Shaanxi University of Chinese Medicine, Shaanxi, China
| | - Aozi Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuai Zheng
- School of Public Health, Shaanxi University of Chinese Medicine, Shaanxi, China
| | - Yunmei Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - You Zeng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China
- *Correspondence: Jun Lyu,
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Ball G, Lemieux C, Cameron D, Seftel MD. Cost-Effectiveness of Brexucabtagene Autoleucel versus Best Supportive Care for the Treatment of Relapsed/Refractory Mantle Cell Lymphoma following Treatment with a Bruton’s Tyrosine Kinase Inhibitor in Canada. Curr Oncol 2022; 29:2021-2045. [PMID: 35323364 PMCID: PMC8946986 DOI: 10.3390/curroncol29030164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/14/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
For patients with Mantle Cell Lymphoma (MCL), there is no recognized standard of care for relapsed/refractory (R/R) disease after treatment with a Bruton’s tyrosine kinase inhibitor (BTKi). Brexucabtagene autoleucel (brexu-cel) represents a promising new treatment modality in MCL. We explored whether brexu-cel was cost-effective for the treatment of R/R MCL. We developed a partitioned survival mixture cure approach to model the costs and outcomes over a lifetime horizon. The clinical data were derived from the ZUMA-2 clinical trial. The costs were estimated from the publicly available Canadian databases, published oncology literature, and pan-Canadian Oncology Drug Review economic guidance reports. The health state utilities were sourced from the ibrutinib submission to the National Institute for Health and Care Excellence for R/R MCL and supplemented with values from the published oncology literature. In the base case over a lifetime horizon, brexu-cel generated an incremental 9.56 life-years and an additional 7.03 quality-adjusted life-years compared to BSC, while associated with CAD 621,933 in additional costs. The resultant incremental cost-utility ratio was CAD 88,503 per QALY gained compared with BSC. Based on this analysis, we found brexu-cel to be a cost-effective use of healthcare resources relative to BSC for treatment of adult patients with R/R MCL previously treated with a BTKi in Canada, though additional research is needed to confirm these results using longer follow-up data.
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Affiliation(s)
- Graeme Ball
- Gilead Sciences Canada, Inc., Mississauga, ON L5N 2W3, Canada;
| | | | - David Cameron
- PIVINA Consulting Inc., Mississauga, ON L4W 5B2, Canada;
| | - Matthew D. Seftel
- Department of Medicine, University of British Columbia, Vancouver, BC V1Y 1T3, Canada
- Canadian Blood Services, Vancouver, BC V6T 1V6, Canada
- Correspondence:
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Incidence of non-Hodgkin’s lymphoma among adults in Sardinia, Italy. PLoS One 2022; 17:e0260078. [PMID: 35108286 PMCID: PMC8809576 DOI: 10.1371/journal.pone.0260078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
The causes of the peculiar time trend in the incidence of non-Hodgkin’s lymphoma (NHL) in most parts of the world and of its geographic distribution are still unknown. We used the data base of 1974–2003 incident cases of hematological malignancies to explore the time trend of NHL incidence in the region of Sardinia, Italy, and we used Bayesian methods to plot the probability of NHL incidence by residential unit on the regional map. In 1974–2003, 4109 NHL cases were diagnosed among resident adults in Sardinia, with an incidence rate of 13.38 x 10−5 (95% CI 12.97–13.80). NHL incidence showed an upward trend along the study period with an average annual percent change (APC) of 4.94 (95% CI -5.39–16.4), which did not vary by gender or by age-group. Cancer registry data, covering part of the region starting from 1993, suggest that the increasing trend did not persist in the subsequent years. Areas with the highest probability of an excess incidence tended to cluster in the north-eastern part of the region and in two major urban centers, with the low incidence areas located in the south, confirming previous observations. Prevalence of viral infections, environmental and occupational exposures, or socio-economic deprivation would not explain the peculiar geographic distribution we observed. These findings provide convincing arguments for extending the coverage of routine cancer registration over the whole Sardinian population, while prompting further research on the genetic and environmental determinants of NHL in the risk areas.
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Alzahrani M, Altowairqi M, Alyousef M, Ghandour M, Alrashed A, Aljebrin Y, Alotheem G. Survival and epidemiologic trends of lymphomas in Saudi Arabia: A 10-year report from a tertiary care hospital. SAUDI JOURNAL OF MEDICINE AND MEDICAL SCIENCES 2022; 10:31-35. [PMID: 35283704 PMCID: PMC8869271 DOI: 10.4103/sjmms.sjmms_200_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/27/2021] [Accepted: 12/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The current trends in lymphoma cases from Saudi Arabia and their long-term survival are unknown. This study was conducted to evaluate the trends of lymphoma diagnoses and survival from a major tertiary care hospital in Saudi Arabia. Methods: This retrospective study included all new cases of lymphoma diagnosed in adults (age ≥18 years) at King Saud University Medical City, Riyadh, Saudi Arabia, from 2008 to 2018, as identified from the Saudi Cancer Registry. Data on the demographics and clinical characteristics were collected, the survival outcomes were estimated, and multivariate analysis of the overall survival was calculated. Results: A total of 422 patients were included (median age: 46 years). The number new cases of lymphoma diagnosed variably increased over the study period: From 28 (7%) cases in 2009 to 48 (11%) in 2018. The most common lymphoma was diffuse large B-cell lymphoma (175; 41%): and extranodal site was GI involvement (33.5%). In terms of survival, 79% were alive at the last follow-up. On multivariable analysis, the hazard ratio (HR) for patients aged ≥60 years was 3.44 (95% CI: 2–5.9; P = 0.0000069), adjusted for lactate dehydrogenase level (LDH) and disease stage. For advanced-stage disease and high LDH, the HR was 4.2 (95% CI: 1.5-11.8, P = 0.00637) and 0.5 (95% CI: 0.28-0.97; P = 0.04106), respectively. Conclusions: The lymphoma trend in the Saudi Arabian population showed variable increase in cases over the study period, with most patients presenting with advanced-stage disease and at a younger age. The overall survival was comparable with studies from Western countries.
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Ocier K, Abdelaziz S, Kim S, Rowe K, Snyder J, Deshmukh V, Newman M, Fraser A, Smith K, Porucznik CA, Shoaf K, Stanford JB, Lee CJ, Hashibe M. Cardiovascular disease risks in younger versus older adult B-cell non-Hodgkin's lymphoma survivors. Cancer Med 2021; 10:4117-4126. [PMID: 33979029 PMCID: PMC8209610 DOI: 10.1002/cam4.3934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/24/2021] [Accepted: 04/03/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction Young cancer survivors may be at increased risk of early‐onset chronic health conditions. The aim of this population‐based study is to estimate cardiovascular disease (CVD) risk among younger versus older B‐cell non‐Hodgkin's lymphoma (B‐NHL) survivors compared with their respective general population cohorts. Methods B‐NHL survivors diagnosed from 1997 to 2015 in the Utah Cancer Registry were matched with up to five cancer‐free individuals on birth year, sex, and birth state, using the statewide Utah Population Database. Electronic medical records and statewide health care facility data were used to identify disease outcomes ≥5 years after cancer diagnosis. Cox Proportional Hazards models were used to estimate hazard ratios for B‐NHL survivors diagnosed at <65 years and ≥65 years old. Results Younger B‐NHL survivors had higher relative risks than older cancer survivors of chronic rheumatic disease of the heart valves (HR = 4.14, 99% CI = 2.17–7.89; P valueheterogeneity = 0.004); peri‐, endo‐, and myocarditis (HR = 2.43, 99% CI = 1.38–4.28; P valueheterogeneity = 0.016); diseases of the arteries (HR = 1.63, 99% CI = 1.21–2.21; P valueheterogeneity = 0.044); and hypotension (HR = 2.44, 99% CI = 1.58–3.75; P valueheterogeneity = 0.048). B‐NHL survivors of both age groups had elevated relative risks of heart disease overall and congestive heart failure. Conclusion Younger B‐NHL survivors had higher risks than older B‐NHL survivors of specific cardiovascular diseases compared to their respective general population cohorts.
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Affiliation(s)
- Krista Ocier
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Seungmin Kim
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Kerry Rowe
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Vikrant Deshmukh
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Michael Newman
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Alison Fraser
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ken Smith
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kimberley Shoaf
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Catherine J Lee
- Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA.,Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
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11
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Dinnessen MA, Visser O, Tonino SH, Poel MW, Blijlevens NM, Kersten MJ, Lugtenburg PJ, Dinmohamed AG. The impact of prior malignancies on the development of second malignancies and survival in follicular lymphoma: A population‐based study. EJHAEM 2020; 1:489-497. [PMID: 35844986 PMCID: PMC9175939 DOI: 10.1002/jha2.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/20/2022]
Abstract
We assessed the impact of a prior malignancy diagnosis (PMD) – as a potential proxy for genetic cancer susceptibility – on the development of a second primary malignancy (SPM) and mortality in follicular lymphoma (FL) patients. From the nationwide Netherlands Cancer Registry, we selected all adult FL patients diagnosed in 1994‐2012 (n = 8028) and PMDs and SPMs relative to FL, with follow‐up until 2017. We constructed two Fine and Gray models – with death as a competing risk – to assess the association between a PMD and SPM incidence. A PMD was associated with an increased incidence of SPMs (subdistribution hazard ratio [SHR], 1.30; 95% confidence interval [CI], 1.03‐1.64) – especially carcinomas of the respiratory tract (SHR, 1.83; 95% CI, 1.10‐3.05) and cutaneous squamous cell carcinomas (SHR, 1.58; 95% CI, 1.01‐2.45) – and a higher risk of mortality in a multivariable model (HR, 1.43; 95% CI, 1.19‐1.71). However, when additionally adjusted for the receipt of systemic therapy and/or radiotherapy before FL diagnosis, only patients who received such therapies had an increased incidence of SPMs (SHR, 1.40; 95% CI, 1.02‐1.93). In conclusion, patients with a PMD had a higher rate of SPMs and mortality than those without a PMD, which might have resulted from therapy‐related carcinogenesis.
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Affiliation(s)
- Manette A.W. Dinnessen
- Department of Research and Development Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht The Netherlands
| | - Otto Visser
- Department of Registration Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht The Netherlands
| | - Sanne H. Tonino
- Department of Hematology Cancer Center Amsterdam LYMMCARE (Lymphoma and Myeloma Center Amsterdam) Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Marjolein W.M. Poel
- Department of Internal Medical Division of Hematology Maastricht University Medical Center Maastricht The Netherlands
| | | | - Marie José Kersten
- Department of Hematology Cancer Center Amsterdam LYMMCARE (Lymphoma and Myeloma Center Amsterdam) Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | | | - Avinash G. Dinmohamed
- Department of Research and Development Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht The Netherlands
- Department of Hematology Cancer Center Amsterdam LYMMCARE (Lymphoma and Myeloma Center Amsterdam) Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
- Amsterdam UMC Vrije Universiteit Amsterdam Department of Hematology Cancer Center Amsterdam Amsterdam The Netherlands
- Department of Public Health Erasmus University Medical Center Rotterdam The Netherlands
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12
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Stage-specific trends in primary therapy and survival in follicular lymphoma: a nationwide population-based analysis in the Netherlands, 1989-2016. Leukemia 2020; 35:1683-1695. [PMID: 33046819 DOI: 10.1038/s41375-020-01048-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/12/2020] [Accepted: 09/29/2020] [Indexed: 11/09/2022]
Abstract
We assessed stage-specific trends in primary therapy and relative survival among adult follicular lymphoma (FL) patients diagnosed in the Netherlands between 1989-2016 (N = 12,372; median age, 62 years; and 21% stage I disease). Patients were stratified by disease stage and subsequently categorized into four calendar periods (1989-1995, 1996-2002, 2003-2008, and 2009-2016) and three age groups (18-60, 61-70, and >70 years). The use of radiotherapy in stage I FL remained relatively stable over time and across the three age groups (i.e., 66%, 54%, and 49% in 2009-2016, respectively). In stage II-IV FL, the start of chemotherapy within 12 months post-diagnosis decreased over time, indicating a broader application of a watch-and-wait approach. Relative survival improved considerably over time, especially since 2003 when rituximab was introduced in the Netherlands, and for stage III-IV FL patients and older age groups. Five-year relative survival for patients with stage I-II versus stage III-IV FL in the period 2009-2016 was 96% versus 90%, 93% versus 83%, and 92% versus 68% across the three age groups, respectively. Collectively, the improvement in survival since 2003 is accounted for by advances in FL management, particularly the implementation of rituximab. There remains, however, room for improvement among elderly stage III-IV FL patients.
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13
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Kim JS, Liu Y, Ha KH, Qiu H, Rothwell LA, Kim HC. Increasing Incidence of B-Cell Non-Hodgkin Lymphoma and Occurrence of Second Primary Malignancies in South Korea: 10-Year Follow-up Using the Korean National Health Information Database. Cancer Res Treat 2020; 52:1262-1272. [PMID: 32599988 PMCID: PMC7577801 DOI: 10.4143/crt.2020.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/30/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The epidemiology of B-cell non-Hodgkin lymphoma (BNHL) in Asia is not well described, and rates of second primary malignancies (SPM) in these patients are not known. We aimed to describe temporal changes in BNHL epidemiology and SPM incidence in Korea. Materials and Methods A retrospective cohort study used claims data from the National Health Insurance Service that provides universal healthcare coverage in Korea. Newly diagnosed patients aged at least 19 years with a confirmed diagnosis of one of six BNHL subtypes (diffuse large cell B-cell lymphoma [DLBCL], small lymphocytic and chronic lymphocytic [CLL/SLL], follicular lymphoma [FL], mantle cell lymphoma [MCL], marginal zone lymphoma [MZL], and lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia [WM]) during the period 2006-2015 were enrolled and followed up until death, dis-enrolment, or study end, whichever occurred first. Patients with pre-existing primary cancers prior to the diagnosis of BNHL were excluded. Results A total of 19,500 patients with newly diagnosed BNHL were identified out of 27,866 with non-Hodgkin lymphoma (NHL). DLBCL was the most frequently diagnosed subtype (41.9%-48.4% of NHL patients annually, 2011-2015). Standardized incidence of the six subtypes studied per 100,000 population increased from 5.74 in 2011 to 6.96 in 2015, with most increases in DLBCL, FL, and MZL. The incidence (95% confidence interval) of SPM per 100 person-years was 2.74 (2.26-3.29) for CLL/SLL, 2.43 (1.57-3.58) for MCL, 2.41 (2.10-2.76) for MZL, 2.23 (2.07-2.40) for DLBCL, 1.97 (1.61-2.38) for FL, and 1.41 (0.69-2.59) for WM. Conclusion BNHL has been increasingly diagnosed in Korea. High rates of SPM highlight the need for continued close monitoring to ensure early diagnosis and treatment.
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Affiliation(s)
- Jin Seok Kim
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yanfang Liu
- Janssen Research & Development, Global Epidemiology, Singapore
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hong Qiu
- Janssen Research & Development, Global Epidemiology, Titusville, NJ, USA
| | | | - Hyeon Chang Kim
- Department of Preventative Medicine, Yonsei University College of Medicine, Seoul, Korea
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14
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Vallet N, Ertault M, Delaye JB, Chalopin T, Villate A, Drieu La Rochelle L, Lejeune J, Foucault A, Eloit M, Barin-Le Guellec C, Hérault O, Colombat P, Gyan E. Hypercalcemia is associated with a poor prognosis in lymphoma a retrospective monocentric matched-control study and extensive review of published reported cases. Ann Hematol 2020; 99:229-239. [PMID: 31907572 DOI: 10.1007/s00277-019-03890-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 12/06/2019] [Indexed: 12/14/2022]
Abstract
The prognostic significance of hypercalcemia in lymphoma has only been studied on small series to date. We conducted a retrospective, monocentric, matched-control study that aimed to compare the outcome of patients diagnosed with any histological subtype of lymphoma associated with hypercalcemia, at diagnosis or relapse, with a group of controls matched for histological and prognostic factors. Sixty-two and 118 comparable patients treated between 2000 and 2016 were included in hypercalcemia and control cohorts, respectively. Hypercalcemia was found mainly at diagnosis (71%) in higher-risk patients (prognosis scores ≥ 3, 76%) and those with diffuse large B cell lymphoma (67.7%), stage III/IV disease (91.9%), and elevated LDH (90.3%). Two-year progression-free survival (PFS) was shorter in the hypercalcemia than control cohort [30.1% (95% confidence interval (95% CI) 18.3-41.9) vs 63.9% (95% CI 5.1-72.7), p < 0.001]. Two-year overall survival (OS) was 40.6% (95% CI 28.1-53.1) and 77.7% (95% CI 70.1-85.3) in the hypercalcemia and control cohorts, respectively (p < 0.001). Hypercalcemia was independently associated with poor PFS [HR = 2.5 (95% CI 1.4-3.5)] and OS [HR = 4.7 (95% CI 2.8-7.8)] in multivariate analysis. Among the 40 patients who received autologous stem cell transplantation (ASCT), hypercalcemia was still associated with shorter OS [2-year OS: 65% (95% CI 40.1-89.9) vs 88.0 (95% CI 75.3-100), p = 0.04]. Hypercalcemia may be associated with chemo-resistance, given its impact on PFS and OS. Hence, these data suggest that alternate strategies for lymphoma patients with hypercalcemia should be developed.
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Affiliation(s)
- Nicolas Vallet
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Marjan Ertault
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Jean-Baptiste Delaye
- Department of Biochemistry and Molecular Biology, University Hospital, Tours, France
| | - Thomas Chalopin
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Alban Villate
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | | | - Julien Lejeune
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Amélie Foucault
- Department of Biological Hematology, University Hospital, Tours, France
| | - Martin Eloit
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | | | - Olivier Hérault
- Department of Biological Hematology, University Hospital, Tours, France.,CNRS ERL7001 LNOx "Leukemic Niche & Redox Metabolism", EA7501 GICC, Tours University, Tours, France
| | - Philippe Colombat
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy, University Hospital, Tours, France. .,CNRS ERL7001 LNOx "Leukemic Niche & Redox Metabolism", EA7501 GICC, Tours University, Tours, France. .,Department of Hematology and Cell Therapy, 2 Boulevard Tonnellé, 37044, Tours Cedex, France.
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15
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Le M, Ghazawi FM, Alakel A, Netchiporouk E, Rahme E, Zubarev A, Powell M, Moreau L, Roshdy O, Glassman SJ, Sasseville D, Popradi G, Litvinov IV. Incidence and mortality trends and geographic patterns of follicular lymphoma in Canada. ACTA ACUST UNITED AC 2019; 26:e473-e481. [PMID: 31548815 DOI: 10.3747/co.26.4625] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Follicular lymphoma (fl) is the most common indolent lymphoma and the 2nd most common non-Hodgkin lymphoma, accounting for 10%-20% of all lymphomas in the Western world. Epidemiologic and geographic trends of fl in Canada have not been investigated. Our study's objective was to analyze incidence and mortality rates and the geographic distribution of fl patients in Canada for 1992-2010. Methods Demographic and geographic patient data for fl cases were obtained using the Canadian Cancer Registry, the Registre québécois du cancer, and the Canadian Vital Statistics database. Incidence and mortality rates and 95% confidence intervals were calculated per year and per geographic area. Rates were plotted using linear regression models to assess trends over time. Overall data were mapped using Microsoft Excel mapping software (Redmond, WA, U.S.A.) to identify case clusters across Canada. Results Approximately 22,625 patients were diagnosed with fl during 1992-2010. The age-standardized incidence rate of this malignancy in Canada was 38.3 cases per million individuals per year. Geographic analysis demonstrated that a number of Maritime provinces and Manitoba had the highest incidence rates, and that the provinces of Nova Scotia and Quebec had the highest mortality rates in the nation. Regional data demonstrated clustering of fl within cities or regions with high herbicide use, primary mining, and a strong manufacturing presence. Conclusions Our study provides a comprehensive overview of the fl burden and its geographic distribution in Canada. Regional clustering of this disease in concentrated industrial zones strongly suggests that multiple environmental factors might play a crucial role in the development of this lymphoma.
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Affiliation(s)
- M Le
- Division of Dermatology, McGill University, Montreal, QC
| | - F M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON
| | - A Alakel
- The Ottawa Hospital Research Institute, Ottawa, ON
| | - E Netchiporouk
- Division of Dermatology, McGill University, Montreal, QC
| | - E Rahme
- Division of Clinical Epidemiology, McGill University, Montreal, QC
| | - A Zubarev
- Division of Dermatology, McGill University, Montreal, QC
| | - M Powell
- Division of Dermatology, McGill University, Montreal, QC
| | - L Moreau
- Division of Dermatology, McGill University, Montreal, QC
| | - O Roshdy
- Division of Dermatology, McGill University, Montreal, QC
| | - S J Glassman
- Division of Dermatology, University of Ottawa, Ottawa, ON
| | - D Sasseville
- Division of Dermatology, McGill University, Montreal, QC
| | - G Popradi
- Division of Hematology, McGill University, Montreal, QC
| | - I V Litvinov
- Division of Dermatology, McGill University, Montreal, QC.,Division of Dermatology, University of Ottawa, Ottawa, ON
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