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Vaughn JL, Spies D, Xavier AC, Epperla N. Racial disparities in the survival of patients with indolent non-Hodgkin lymphomas in the United States. Am J Hematol 2021; 96:816-822. [PMID: 33864695 DOI: 10.1002/ajh.26198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/26/2021] [Accepted: 04/14/2021] [Indexed: 11/09/2022]
Abstract
There is a paucity of data regarding racial disparities in the survival of patients with indolent non-Hodgkin lymphomas (iNHL) in the contemporary time-period. Hence, we sought to determine whether racial disparities exist in the survival of patients with iNHLs in the US. We included 68 059 adult patients with follicular lymphoma (FL, n = 41 943), marginal zone lymphoma (MZL, n = 22 485), and lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM, n = 3631) who were diagnosed in the US between 2000 and 2017. Race was categorized as White, Black, Asian/Pacific Islander, or American Indian/Alaska Native (API/AI). The primary outcome was relative survival (RS), which was estimated using flexible parametric survival models. The RS estimates varied according to race and disease histology but were consistently lower for racial minorities, including those diagnosed during the most recent 5-year time-period of 2012-2017. On multivariable analysis for RS, Black patients with FL had a 32% higher excess mortality rate compared to White patients [adjusted excess hazard ratio (aEHR), 1.32; 95% CI, 1.15-1.51; p < .001], corresponding to a difference of 55 (95% CI, 24-86) excess deaths per 10 000 person-years. For MZL, Black patients had a 40% higher excess mortality rate compared to White patients (aEHR 1.40; 95% CI, 1.18-1.66; p < .001), corresponding to a difference of 62 (95% CI, 26-98) excess deaths per 10 000 person-years. No significant racial differences were detected for patients with WM. The greatest disparity was seen for younger Black patients with FL. Our findings highlight the need for interventions to improve the outcomes of Black patients with iNHLs, particularly younger Black patients with FL.
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Affiliation(s)
- John L Vaughn
- Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
- Clinical Epidemiology and Health Services Research Program, Weill Cornell Medicine, New York, New York, USA
| | | | - Ana C Xavier
- Division of Hematology and Oncology, Children's of Alabama/University of Alabama at Birmingham, Birmingham, Alabama, USA
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Conditional relative survival among patients with follicular lymphoma: a population-based study in the Netherlands. Blood Cancer J 2021; 11:12. [PMID: 33441537 PMCID: PMC7806661 DOI: 10.1038/s41408-020-00399-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/30/2020] [Accepted: 12/10/2020] [Indexed: 11/09/2022] Open
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Florindez JA, Alderuccio JP, Reis IM, Lossos IS. Survival analysis in treated plasmablastic lymphoma patients: a population-based study. Am J Hematol 2020; 95:1344-1351. [PMID: 32777103 DOI: 10.1002/ajh.25955] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/19/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Herein we analyzed survival outcomes in chemotherapy-treated patients with plasmablastic lymphoma (PBL) diagnosed between 2010 to 2016 (n = 248). Data was acquired from the Surveillance, Epidemiology, and End Results (SEER) 18 registries database (April 2019 release based on November 2018 submission). The majority of patients were male (81.9%) and younger than 60 years (71.0%). Oral and gastrointestinal (GI) sites were the most frequent primary extranodal locations (23% and 19.4%, respectively). Oral primary location was inversely associated with presence of B symptoms and advanced Ann-Arbor stage. The 3-year and 5-year overall survival (OS) rates of treated PBL patients were 54% (95% CI: 46.5%-60.8%) and 52.8% (95% CI: 45.2%-59.8%). Three-year conditional survival for 2-year and 3-year survivors were 90.3% and 97.8%, overlapping the survival of a general population matched by age, sex and calendar year. In a multivariable analysis, oral primary location was associated with not only better OS (HR 0.43; 95% CI: 0.21-0.88, P = .021) but also better lymphoma-specific survival (LSS) (SHR 0.36; 95% CI: 0.15-0.86, P = .022); age ≥60 years was associated with shorter LSS (SHR 1.73; 95% CI: 1.02-2.96, P = .043). Seven registries granted access to HIV status (n = 93) where HIV infection was detected in 52.7% of cases. The HIV status did not affect survival outcomes in unadjusted and adjusted analyses. We identified clinical characteristics associated with survival and showed that treated PBL patients may achieve long-term survival.
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Affiliation(s)
- Jorge A. Florindez
- Division of Hospital Medicine, Miller School of Medicine University of Miami Miami Florida
| | - Juan P. Alderuccio
- Divison of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, Miller School of Medicine University of Miami Miami Florida
| | - Isildinha M. Reis
- Department of Public Health Science, Sylvester Comprehensive Cancer Center, Miller School of Medicine University of Miami Miami Florida
- Biostatistics and Bioinformatics Core Resource, Sylvester Comprehensive Cancer Center, Miller School of Medicine University of Miami Miami Florida
| | - Izidore S. Lossos
- Divison of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, Miller School of Medicine University of Miami Miami Florida
- Department of Molecular and Cellular Pharmacology University of Miami Miami Florida
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Monga N, Garside J, Quigley J, Hudson M, O'Donovan P, O'Rourke J, Tapprich C, Parisi L, Davids MS, Tam C. Systematic literature review of the global burden of illness of mantle cell lymphoma. Curr Med Res Opin 2020; 36:843-852. [PMID: 32162977 DOI: 10.1080/03007995.2020.1742101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Mantle cell lymphoma (MCL), a rare and aggressive disease, accounts for approximately 5% of all B-cell non-Hodgkin's lymphomas. Evidence on the burden of this disease, for patients and healthcare providers, is scarce.Methods: Four systematic literature reviews were developed to identify epidemiological, real-world clinical, economic and humanistic burden data on patients with MCL. Electronic databases searched included MEDLINE and Embase, NHS EED and Econlit.Results: Eight epidemiological studies, 19 clinical burden, 2 economic impact and 0 quality of life studies were identified. The range of standardized MCL incidence rates was 0.1-1.27/100,000. Overall survival rates of patients at 3 years differed by age at diagnosis (≤65 years: 76-81%, >65 years: 46-64%) and disease stage (stage I: 73-80%, stage IV: 48-53%). Outcomes were poorer in previously treated patients, and those with later stage or blastoid disease, and improved with more recent diagnosis/treatment. Hospitalization is a major contributor to healthcare cost and differs by therapy toxicity.Conclusions: We identified significant data gaps for many G20 countries for epidemiology, real-world clinical, economic and humanistic burden. These literature reviews demonstrate the ongoing unmet need for MCL patients globally. Future research to further understand the real-world impact of MCL is needed along with new therapeutic options to improve patient outcomes.
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Affiliation(s)
- Neerav Monga
- Health Economics and Reimbursement, Janssen Inc., Toronto, Canada
| | | | | | | | | | | | | | - Lori Parisi
- Global Medical Affairs, Janssen Global Services LLC, Titusville, NJ, USA
| | - Matthew S Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Medicine, Harvard Medical School, Boston, MA, USA
| | - Constantine Tam
- Haematology, St Vincent's Hospital, Melbourne, Australia
- Hematology Department, Peter MacCallum Cancer Center, Melbourne, Australia
- Hematology, University of Melbourne, Melbourne, Australia
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Narita S, Nomura K, Hatakeyama S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Sato H, Mitsuzuka K, Tochigi T, Tsuchiya N, Ohyama C, Arai Y, Nagashima K, Habuchi T. Changes in conditional net survival and dynamic prognostic factors in patients with newly diagnosed metastatic prostate cancer initially treated with androgen deprivation therapy. Cancer Med 2019; 8:6566-6577. [PMID: 31508900 PMCID: PMC6825980 DOI: 10.1002/cam4.2502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to identify predictive factors associated with conditional net survival in patients with metastatic hormone-naive prostate cancer (mHNPC) initially treated with androgen deprivation therapy (ADT). METHODS At nine hospitals in Tohoku, Japan, the medical records of 605 consecutive patients with mHNPC who initially received ADT were retrospectively reviewed. The Pohar Perme estimator was used to calculate conditional net cancer-specific survival (CSS) and overall survival (OS) for up to 5 years subsequent to the diagnosis. Using multiple imputation, proportional hazard ratios for conditional CSS and OS were calculated with adjusted Cox regression models. RESULTS During a median follow up of 2.95 years, 208 patients died, of which 169 died due to progressive prostate cancer. At baseline, the 5-year CSS and OS rates were 65.5% and 58.2%, respectively. Conditional 5-year net CSS and OS survival gradually increased for all the patients. In patients given a 5-year survivorship, the conditional 5-year net CSS and OS rates improved to 0.906 and 0.811, respectively. Only the extent of disease score (EOD) ≥2 remained a prognostic factor for CSS and OS up to 5 years; as survival time increased, other variables were no longer independent prognostic factors. CONCLUSIONS The conditional 5-year net CSS and OS in patients with mHNPC gradually increased; thus, the risk of mortality decreased with increasing survival. The patient's risk profile changed over time. EOD remained an independent prognostic factor for CSS and OS after 5-year follow-up. Conditional net survival can play a role in clinical decision-making, providing intriguing information for cancer survivors.
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Affiliation(s)
- Shintaro Narita
- Department of Urology, Akita University School of Medicine, Akita, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Kyoko Nomura
- Department of Public Health, Akita University School of Medicine, Akita, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Masahiro Takahashi
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, Natori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Senji Hoshi
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Masanori Ishida
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Shigeto Ishidoya
- Department of Urology, Sendai City Hospital, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Tatsuo Tochigi
- Department of Urology, Miyagi Cancer Center, Natori, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University School of Medicine, Yamagata, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Yoichi Arai
- Department of Urology, Tohoku University School of Medicine, Sendai, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
| | - Kengo Nagashima
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Minato-ku, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Akita, Japan.,Michinoku Japan Urological Cancer Study Group (MJUCSG), Minato-ku, Japan
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Bersvendsen HS, Haugnes HS, Fagerli UM, Fluge Ø, Holte H, Smeland KB, Wilsgaard T, Kiserud CE. Lifestyle behavior among lymphoma survivors after high-dose therapy with autologous hematopoietic stem cell transplantation, assessed by patient-reported outcomes. Acta Oncol 2019; 58:690-699. [PMID: 30696346 DOI: 10.1080/0284186x.2018.1558370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: High-dose therapy with autologous stem cell transplantation (HD-ASCT) is associated with an increased risk of late effects. Our aim was to assess lifestyle behavior and factors associated with unhealthy lifestyle among HD-ASCT-treated lymphoma survivors (HD-ASCT-LS). Materials and methods: We conducted a national cross-sectional study of HD-ASCT-LS treated during 1987-2008. Among 399 eligible participants, 312 (78%) completed patient-reported outcome measures (PROMs) on lifestyle behavior (physical activity, overweight, smoking and alcohol consumption), chronic fatigue (CF) and somatic and mental illness. We assessed lifestyle according to WHO recommendations. Multivariable logistic regression models were used to study associations between variables. A comparison to the general population was performed. Results: Mean age at survey was 54.6 years, 60% were men, 55% sedentary, 55% overweight, 18% smokers and 5% had unhealthy alcohol consumption. Being sedentary was positively associated with older age, low household income, CF and higher somatic burden (≥4 self-reported somatic conditions). Overweight was positively associated with male gender and negatively associated with increased number of chemotherapy regimens prior to HD-ASCT. Current smoking was positively associated with living alone and CF, and negatively associated with older age. Male gender, CF and higher somatic burden increased the risk of an unhealthier lifestyle whereas the increased number of chemotherapy regimens prior to HD-ASCT decreased the risk. HD-ASCT-LS were significantly less sedentary, less overweight, and had a lower likelihood of smoking than the controls. Discussion: Assessed by PROMs, unhealthy habits were frequent among HD-ASCT-LS and associated with comorbidity. Nevertheless, compared with controls significantly more HD-ASCT-LS met lifestyle recommendations. These results indicate that the HD-ASCT-LS may consist of two groups, the adhering group with less comorbidity and the non-adhering group with more comorbidity. Our findings illustrate the necessity of recommendations and support for improving health-related behavior in cancer survivorship plans in order to empower survivors in their life beyond cancer.
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Affiliation(s)
- Hanne Skjerven Bersvendsen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT-The Arctic University of Norway, Tromsø, Norway
| | - Hege Sagstuen Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UIT-The Arctic University of Norway, Tromsø, Norway
| | - Unn-Merete Fagerli
- Department of Oncology, St. Olav’s Hospital, Trondheim, Norway
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øystein Fluge
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Harald Holte
- Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- K.G. Jebsen-Centre for B Cell Malignancies, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Knut Bjøro Smeland
- Department of Oncology, National Advisory Unit for Late Effects After Cancer, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UIT-The Arctic University of Norway, Tromsø, Norway
| | - Cecilie Essholt Kiserud
- Department of Oncology, National Advisory Unit for Late Effects After Cancer, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
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Monga N, Nastoupil L, Garside J, Quigley J, Hudson M, O’Donovan P, Parisi L, Tapprich C, Thieblemont C. Burden of illness of follicular lymphoma and marginal zone lymphoma. Ann Hematol 2018; 98:175-183. [DOI: 10.1007/s00277-018-3501-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/17/2018] [Indexed: 12/11/2022]
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Zhang G, Li R, Deng Y, Zhao L. Conditional survival of patients with hepatocellular carcinoma: results from the Surveillance, Epidemiology, and End Results registry. Expert Rev Gastroenterol Hepatol 2018. [PMID: 29543072 DOI: 10.1080/17474124.2018.1453806] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Compared with overall survival, conditional survival is a more relevant measure of prognosis in surviving patients over time. The aim of this study was to describe the conditional survival of patients with hepatocellular carcinoma according to different prognostic variables through an analysis of a national population-based cancer registry. METHODS We analyzed data from 3,082 hepatocellular carcinoma patients who were diagnosed between 2004 and 2014. RESULTS The conditional overall and cause-specific survival improved from 37.6% to 68.9% and 45% to 79.1%, respectively, in the entire study population. The conditional overall and cause-specific survival improved from 32.6% to 69.3% and 40.1% to 74.8%, respectively, in patients aged 65 to 74 years. The conditional overall and cause-specific survival improved from 8.4% to 44.1% and 12.1% to 66.1%, respectively, in the stage IVB group. The conditional overall and cause-specific survival improved from 32.8% to 71.4% and 40.3% to 78.4%, respectively, in the positive/elevated AFP group. CONCLUSIONS Conditional survival exhibited an improved prognosis over time. For hepatocellular carcinoma patients who survived for a specific period of time after diagnosis, more dramatic improvements occurred in patients aged 65-74 years, patients with AJCC stage IVB, and patients with a positive/elevated AFP value.
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Affiliation(s)
- Guoqing Zhang
- a Department of Hepatobiliary and pancreatic surgery , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Renfeng Li
- a Department of Hepatobiliary and pancreatic surgery , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yilei Deng
- a Department of Hepatobiliary and pancreatic surgery , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Longshuan Zhao
- a Department of Hepatobiliary and pancreatic surgery , First Affiliated Hospital of Zhengzhou University , Zhengzhou , China
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