RESUMEN
BACKGROUND: Non-Hodgkin lymphoma (NHL) has been identified as a significant contributor to the cancer burden. This study investigates the incidence, mortality, and survival trends of NHL cancer in Brunei Darussalam from 2011 to 2020. METHODS: This is a registry-based retrospective study using de-identified data from the Brunei Darussalam Cancer Registry on patients diagnosed with NHL from 2011 to 2020 based on the ICD-10 codes C82-86. Statistical methods include descriptive statistics, age-specific and age-standardised incidence (ASIR) and mortality rates (ASMR), and joinpoint regression for trend analysis. Survival analysis was conducted using Kaplan-Meier plots, log-rank test, and Cox Proportional Hazards regression. RESULTS: From 2011 to 2020, 330 patients were diagnosed with NHL. The majority of patients were males (51.8%) and of Malay descent (82.7%). The age group most diagnosed was 55-74 years (42.3%), with a mean age at diagnosis being 55.1 years. The ASIRs were 12.12 for males and 10.39 per 100,000 for females; ASMRs were 6.11 for males and 4.76 per 100,000 for females. Diffuse large B-cell lymphoma was the most prevalent subtype, accounting for 39.1% of cases. The overall 5-year survival rate was 61.2%, with lower rates observed in older patients and those diagnosed at distant metastasis stage. Furthermore, older age and advanced stage diagnosis significantly increased mortality risk. NHL incidence and mortality rates in Brunei Darussalam remain stable over the period of 10 years, but highlights significant disparities in gender and age. CONCLUSIONS: The findings emphasize the importance of early detection and tailored treatments, especially for high-risk groups, in managing NHL's burden. These insights underline the need for focused healthcare strategies and continued research to address NHL's challenges.
Asunto(s)
Linfoma no Hodgkin , Humanos , Masculino , Femenino , Brunei/epidemiología , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/mortalidad , Persona de Mediana Edad , Incidencia , Anciano , Estudios Retrospectivos , Adulto , Adulto Joven , Sistema de Registros , Anciano de 80 o más Años , Adolescente , Niño , Preescolar , Lactante , Tasa de SupervivenciaRESUMEN
Immune dysregulation in autoimmune diseases (ADs) is a risk factor for the development of Non-Hodgkin's lymphoma (NHL). However, the underlying mechanisms are not well understood. Hence, this retrospective study aims to describe the clinical and demographic factors that increase the risk of NHL development in patients with ADs. Our study utilised data from National Inpatient Sample (NIS) for the duration of 2016-2020 on all adult patients aged > 18 years who had NHL. We divided them into two cohorts: one with underlying ADs and one without underlying ADs. We then compared the adjusted odds ratios (aOR) of various risk factors. It was found that 0.9% of autoimmune cases had NHL, while 0.7% of non-autoimmune cases had NHL. Among those with autoimmune conditions, various factors influenced the presence of lymphoma, such as personal history of chemotherapy or radiation, family history of lymphoid malignancy, HIV infection, advanced age of 60-69 years, Asian and Pacific Islander ethnicity and viral hepatitis. The increased risk of NHL with autoimmune conditions is well established. Studies have also shown that these patients can overall have a poor prognosis from their NHL when compared to patients without autoimmune diseases. However, there is limited literature regarding the interplay of traditional NHL risk factors with underlying autoimmunity. Hence, our study sheds light on the lesser studied risk factors, such as patient characteristics and comorbidities.
Asunto(s)
Enfermedades Autoinmunes , Bases de Datos Factuales , Linfoma no Hodgkin , Humanos , Enfermedades Autoinmunes/epidemiología , Enfermedades Autoinmunes/complicaciones , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/etiología , Persona de Mediana Edad , Factores de Riesgo , Femenino , Anciano , Masculino , Estudios Retrospectivos , Adulto , Anciano de 80 o más Años , Adolescente , Adulto JovenRESUMEN
OBJECTIVES: The Seveso accident (1976) caused the contamination with 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) in an area north of Milan, Italy. We report the results of the update of mortality and cancer incidence in the exposed population through 2013. METHODS: The study cohort includes subjects living in three contaminated zones with decreasing TCDD soil concentrations (zone A, B and R) and in a surrounding uncontaminated territory (reference). Poisson models stratified/adjusted for gender, age and period were fitted to calculate rate ratios (RRs) and 95% CIs. RESULTS: In zone A in males, we found elevated mortality from circulatory diseases in the first decade after the accident (17 deaths, RR 2.00, 95% CI 1.24 to 3.23). In females, mortality from diabetes mellitus was increased, with a positive trend across zones. Incidence of soft tissue sarcoma was increased in males in zone R in the first decade (6 cases, RR 2.62, 95% CI 1.01 to 6.83). In females in zone B, there was an excess of non-Hodgkin's lymphoma after 30 years (6 cases, RR 2.87, 95% CI 1.14 to 7.23). Multiple myeloma was increased in the second decade in females in zone B (4 cases, RR 5.09, 95% CI 1.82 to 14.2) and in males in zone R (11 cases, RR 2.15, 95% CI 1.08 to 4.26). In males in zone R, there was a leukaemia excess after 30 years (23 cases, RR 2.02, 95% CI 1.04 to 3.93). CONCLUSIONS: Although with different patterns across gender, zone and time, we confirmed previous results of increased cardiovascular diseases, diabetes, soft tissue sarcoma, and lymphatic and haematopoietic cancers.
Asunto(s)
Exposición a Riesgos Ambientales , Neoplasias , Dibenzodioxinas Policloradas , Humanos , Masculino , Italia/epidemiología , Femenino , Incidencia , Neoplasias/epidemiología , Neoplasias/mortalidad , Neoplasias/etiología , Persona de Mediana Edad , Adulto , Exposición a Riesgos Ambientales/efectos adversos , Anciano , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/mortalidad , Diabetes Mellitus/epidemiología , Sarcoma/epidemiología , Sarcoma/mortalidad , Sarcoma/inducido químicamente , Adulto Joven , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/mortalidad , Linfoma no Hodgkin/inducido químicamente , Liberación de Peligros Químicos/estadística & datos numéricos , Estudios de Cohortes , Adolescente , Contaminantes del Suelo/efectos adversos , Contaminantes del Suelo/análisisRESUMEN
Background/Aims: Inflammatory bowel disease (IBD) may contribute to the development of hematologic malignancies. In this study, the potential relationship between IBD and hematologic malignancies was investigated. Methods: We searched the PubMed, Web of Science, Embase, and Cochrane Library databases for all cohort studies comparing the incidence of hematologic malignancies in non-IBD populations with that in IBD patients, and we extracted relevant data from January 2000 to June 2023 for meta-analysis. Results: Twenty cohort studies involving 756,377 participants were included in this study. The results showed that compared with the non-IBD cohort, the incidence of hematologic malignancies in the IBD cohort was higher (standardized incidence ratio [SIR]=3.05, p<0.001). According to the specific types of IBD, compared with the non-IBD patients, the incidences of hematologic malignancies in ulcerative colitis patients (SIR=2.29, p=0.05) and Crohn's disease patients (SIR=3.56, p=0.005) were all higher. In the subgroup analysis of hematologic malignancy types, compared with the control group, the incidences of non-Hodgkin's lymphoma (SIR=1.70, p=0.01), Hodgkin's lymphoma (SIR=3.47, p=0.002), and leukemia (SIR=3.69, p<0.001) were all higher in the IBD cohort. Conclusions: The incidence of hematologic malignancies, including non-Hodgkin's lymphoma, Hodgkin's lymphoma, and leukemia is higher in patients with IBD (ulcerative colitis or Crohn's disease) than in non-IBD patients.
Asunto(s)
Neoplasias Hematológicas , Enfermedades Inflamatorias del Intestino , Humanos , Neoplasias Hematológicas/epidemiología , Neoplasias Hematológicas/etiología , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/epidemiología , Incidencia , Estudios de Cohortes , Masculino , Femenino , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/epidemiología , Factores de Riesgo , Adulto , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/epidemiología , Persona de Mediana Edad , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/etiologíaRESUMEN
BACKGROUND: Spinal cord compression is a rare presentation of non-Hodgkin lymphoma (NHL) in children. We aimed to describe the prevalence, histological subtypes, clinical presentation, therapy, and outcome of those children in a population-based cohort. The chemotherapy regimen remained comparable over time. METHODS: We retrospectively identified all children and adolescents with paresis as initial manifestations of the NHL between January 1990 and December 2020 from the NHL-BFM database. Characteristics, therapy, and outcome data were gathered from the database and patient files. RESULTS: Fifty-seven of 4779 children (1.2%) presented with initial paresis due to spinal cord compression. The median age was 10.3 years (range, 3.1-18.0 years), and 33% were female. Initial symptoms were paresis/weakness (n = 50, 88%), back pain (n = 33, 58%), paresthesia (n = 23, 40%), and bladder dysfunction and/or constipation (n = 22, 39%), persisting for a median of 14 days before diagnosis. Subtype distribution was mature B-NHL (n = 41, 72%), precursor B-lymphoblastic lymphoma (LBL) (n = 12, 21%), anaplastic large cell lymphoma (ALCL) (n = 3, 5%), and T-LBL (n = 1, 2%). Initial emergency therapy included surgery (70%) and/or chemotherapy/steroids (63%). Five-year event-free survival and overall survival (80% ± 5% and 82% ± 5%, respectively) were comparable with all other NHL patients. Neurological symptoms persisted in approximately one-third of surviving patients at the last follow-up. CONCLUSION: 1.2% of pediatric NHL patients presented with paresis from spinal cord compression mainly due to B-cell lymphomas. Neurological sequelae were observed in one-third of surviving patients.
Asunto(s)
Linfoma no Hodgkin , Compresión de la Médula Espinal , Humanos , Femenino , Masculino , Niño , Adolescente , Estudios Retrospectivos , Preescolar , Compresión de la Médula Espinal/etiología , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/patología , Linfoma no Hodgkin/epidemiología , Tasa de Supervivencia , Pronóstico , Estudios de SeguimientoRESUMEN
Spatial cluster analyses are commonly used in epidemiologic studies of case-control data to detect whether certain areas in a study region have an excess of disease risk. Case-control studies are susceptible to potential biases including selection bias, which can result from non-participation of eligible subjects in the study. However, there has been no systematic evaluation of the effects of non-participation on the findings of spatial cluster analyses. In this paper, we perform a simulation study assessing the effect of non-participation on spatial cluster analysis using the local spatial scan statistic under a variety of scenarios that vary the location and rates of study non-participation and the presence and intensity of a zone of elevated risk for disease for simulated case-control studies. We find that geographic areas of lower participation among controls than cases can greatly inflate false-positive rates for identification of artificial spatial clusters. Additionally, we find that even modest non-participation outside of a true zone of elevated risk can decrease spatial power to identify the true zone. We propose a spatial algorithm to correct for potentially spatially structured non-participation that compares the spatial distributions of the observed sample and underlying population. We demonstrate its ability to markedly decrease false positive rates in the absence of elevated risk and resist decreasing spatial sensitivity to detect true zones of elevated risk. We apply our method to a case-control study of non-Hodgkin lymphoma. Our findings suggest that greater attention should be paid to the potential effects of non-participation in spatial cluster studies.
Asunto(s)
Análisis Espacial , Humanos , Análisis por Conglomerados , Estudios de Casos y Controles , Sesgo de Selección , Simulación por Computador , Algoritmos , Linfoma no Hodgkin/epidemiologíaRESUMEN
INTRODUCTION: HIV infection is one of the complex aetiologies of non-Hodgkin's lymphoma (NHL). However, the contribution of HIV to burden of NHL across time and region has not yet been comprehensively reported and quantified. Thus, this study aims to evaluate the relative risk of NHL in individuals with HIV infection compared with those without by performing a comprehensive meta-analysis. Additionally, we intend to further estimate quantitatively the degree of HIV contributing to burden of NHL using population attributable fraction (PAF) modelling analysis. METHODS AND ANALYSIS: This study will screen a mass of records searched from four electronic databases (PubMed, Embase, Cochrane Library and Web of Science). The main outcomes are specific effect values and corresponding 95% CIs for NHL among population with HIV infection compared with those without to quantify the association between HIV infection and NHL. After quality assessment and data extraction, we will undertake a meta-analysis to calculate the pooled risk ratio (RR). Furthermore, PAF calculation based on pooled RR combines with number of age-specific disability-adjusted life year (DALY) and HIV prevalence data (aged ≥15 years old) from 1990 to 2019, at global, regional and country levels. We will calculate the PAF, HIV-associated DALY number and age-standardised rate to quantify the burden of HIV-associated NHL. ETHICS AND DISSEMINATION: This study is based on published articles; thus, the ethic approval is not essential. In addition, we intend to publish the results on peer-reviewed journals for more discussion. We believe that research on estimating global burden of NHL can provide valuable insights for developing targeted prevention and control strategies, thereby achieving significant benefits. PROSPERO REGISTRATION NUMBER: CRD 42023404150.
Asunto(s)
Infecciones por VIH , Linfoma no Hodgkin , Humanos , Linfoma no Hodgkin/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Metaanálisis como Asunto , Salud Global , Proyectos de Investigación , Prevalencia , Años de Vida Ajustados por Discapacidad , Costo de EnfermedadRESUMEN
OBJECTIVE: Recent studies have found a high prevalence of hepatitis B virus (HBV) infection in patients with non-Hodgkin's lymphoma (NHL), especially B-cell non-Hodgkin's lymphoma (B-NHL). However, most studies did not classify it and analyze the correlation between HBV and its various subtypes. METHODS: The authors retrospectively analyzed 1424 patients with lymphoma. Differences in the prevalence of HBV infection in patients with different pathological types of lymphoma were analyzed. The clinical characteristics, progression-free survival (PFS), and overall survival (OS) of HBV-positive and negative B-NHL subtypes were compared according to HBV infection. RESULTS: The HBV infection rate in NHL patients was 7.65%, which was higher than that in HL patients (2.59%, p < 0.05). The HBV infection rate in the B-NHL was higher than that in the T-cell non-Hodgkin's lymphoma (T-NHL) (8.14% vs. 4.95%). The HBV infection rate in the aggressive B-NHL was similar to that of the indolent B-NHL (8.30% vs. 7.88%), and the highest HBV infection rates were found in diffuse large B-cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma, but no significant differences in clinical characteristics, PFS, and OS were seen between HBV-positive and negative patients in the two subtypes. CONCLUSIONS: There was an association between HBV infection and the development of NHL and HBV infection may play a role in the pathogenesis of B-NHL, but not T-NHL.
Asunto(s)
Virus de la Hepatitis B , Hepatitis B , Humanos , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Hepatitis B/complicaciones , Hepatitis B/virología , Hepatitis B/epidemiología , Adulto , Anciano , Virus de la Hepatitis B/aislamiento & purificación , Adulto Joven , Prevalencia , Linfoma no Hodgkin/virología , Linfoma no Hodgkin/epidemiología , Adolescente , Anciano de 80 o más Años , Linfoma de Células B/virología , Linfoma de Células B/epidemiología , Linfoma de Células B/patología , Linfoma de Células B/mortalidad , Supervivencia sin ProgresiónRESUMEN
BACKGROUND: Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) are persistent organic pollutants emitted from industrial sources. Residential proximity to these emissions has been associated with risk of non-Hodgkin lymphoma (NHL) in a limited number of studies. METHODS: We evaluated associations between residential proximity to PCDD/F-emitting facilities and NHL in the NIH-AARP Diet and Health Study (N = 451,410), a prospective cohort enrolled in 1995-1996 in 6 states and 2 U.S. cities. We linked enrollment addresses with a U.S. Environmental Protection Agency database of 4,478 historical PCDD/F sources with estimated toxic equivalency quotient (TEQ) emissions. We evaluated associations between NHL and exposures during a historical period prior to enrollment (1980-1995) using an average emissions index, weighted by toxicity, distance, and wind direction (AEI-W [g TEQ/km2]) within 3-, 5- and 10 km of residences. We also evaluated proximity-only metrics indicating the presence/absence of one or more facilities within each distance, and metrics calculated separately for each facility type. We used Cox regression to estimate associations (hazard ratio, HR; 95 % confidence interval, 95 %CI) with NHL and major subtypes, adjusting for demographic, lifestyle, and dietary factors. RESULTS: A total of 6,467 incident cases of NHL were diagnosed through 2011. Participants with an AEI-W ≥ 95th percentile had elevated risk of NHL compared to those unexposed at 3 km (HR = 1.16; 95 %CI = 0.89-1.52; p-trend = 0.24), 5 km (HR = 1.20;95 %CI = 0.99-1.46;p-trend = 0.05) and 10 km (HR = 1.15; 95 %CI = 0.99-1.34; p-trend = 0.04). We found a positive association at 5 km with follicular lymphoma (HR≥95vs.0 = 1.62; 95 %CI = 0.98-2.67; p-trend = 0.05) and a suggestive association for diffuse large B-cell lymphoma (HR≥95vs.0 = 1.40; 95 %CI = 0.91-2.14; p-trend = 0.11). NHL risk was also associated with high emissions from coal-fired power plants within 10 km (HR≥95vs.0 = 1.42; 95 %CI = 1.09-1.84; p-trend = 0.05). CONCLUSIONS: Residential proximity to relatively high dioxin emissions from industrial sources may increase the risk of NHL and specific subtypes.
Asunto(s)
Linfoma no Hodgkin , Humanos , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/inducido químicamente , Persona de Mediana Edad , Estados Unidos/epidemiología , Masculino , Femenino , Dioxinas/análisis , Anciano , Exposición a Riesgos Ambientales/estadística & datos numéricos , Estudios Prospectivos , Contaminantes Atmosféricos/análisisRESUMEN
Primary Sjögren's syndrome (pSS), a chronic autoimmune condition, has been associated with an increased risk of several cancers. This study aims to delve into the relationship between pSS and the potential development of non-Hodgkin's lymphoma (NHL) utilizing an in-depth systematic review and meta-analysis approach. To thoroughly explore the topic, we conducted a thorough examination of the literature, drawing from reputable databases such as ProQuest, PubMed, Web of Science, Cochrane, and Google Scholar. Our data collection spanned until February 8, 2024, with no time limitation. Data were analyzed with Stata 14 software at a significance threshold of p < 0.05. We examined 15 cohort studies encompassing a total of 50,308 individuals from 1997 to 2023. The findings revealed a substantial link between pSS and the risk of NHL, evident across all demographics. Specifically, the standardized incidence ratio (SIR) was generally 8.78 (95% CI 5.51, 13.99), with similar trends observed in both men (SIR, 6.29; 95% CI 1.93, 20.51) and women (SIR, 9.60; 95% CI 5.89, 15.63). Additionally, the SIR (10.50 (95% CI 7, 15.75)), HR (2.82 (95% CI 1.28, 6.18)), and OR (10.50 (95% CI 3.04, 36.28)) indices further supported this association. Furthermore, the risk of non-NHL associated with pSS was noticeable across different age groups of 40-49 years (SIR, 30.13; 95% CI 14.62, 62.08), 50-59 years (SIR, 9.12; 95% CI 5.13, 16.19), and 60-69 years (SIR, 9; 95% CI 4.68, 17.32). pSS substantively augments the likelihood of NHL manifestation. It notably impacts females and those in earlier stages of adulthood with more acuity than males and older cohorts.
Asunto(s)
Linfoma no Hodgkin , Síndrome de Sjögren , Síndrome de Sjögren/epidemiología , Síndrome de Sjögren/complicaciones , Humanos , Linfoma no Hodgkin/epidemiología , Incidencia , Estudios de Cohortes , Factores de Riesgo , Femenino , MasculinoRESUMEN
The frontline immuno-chemotherapy regimen for HIV-associated non-Hodgkin Lymphoma is dose-adjusted EPOCH ± R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab). Chemotherapy-induced peripheral neuropathy (CIPN), caused by vincristine, is a common adverse effect of EPOCH ± R, negatively impacting long-term patient outcomes. The primary objective of this study was to determine the incidence of CIPN, stratified by HIV status, in patients treated with EPOCH ± R. A retrospective cohort study at a tertiary referral comprehensive cancer center evaluated patients treated with EPOCH ± R from 2011 to 2018. The final sample included 27 patients with HIV compared to 279 without HIV (total n = 306). Overall, the incidence of CIPN was 29.4% (n = 90), including 5 with HIV (18.5%) and 85 without HIV (30.5%). Propensity scores were used to match patients by HIV status. Although no relationship was found between HIV status and neuropathy, CIPN affects too many undergoing treatments for lymphoma, supporting future investigations to minimize toxicities.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Ciclofosfamida , Doxorrubicina , Etopósido , Infecciones por VIH , Linfoma no Hodgkin , Enfermedades del Sistema Nervioso Periférico , Prednisona , Rituximab , Vincristina , Humanos , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Enfermedades del Sistema Nervioso Periférico/epidemiología , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Ciclofosfamida/efectos adversos , Ciclofosfamida/uso terapéutico , Linfoma no Hodgkin/tratamiento farmacológico , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/complicaciones , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Vincristina/efectos adversos , Vincristina/uso terapéutico , Rituximab/efectos adversos , Rituximab/administración & dosificación , Doxorrubicina/efectos adversos , Doxorrubicina/uso terapéutico , Prednisona/efectos adversos , Prednisona/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/complicaciones , Etopósido/efectos adversos , Etopósido/administración & dosificación , Etopósido/uso terapéutico , Adulto , Anciano , IncidenciaRESUMEN
PURPOSE: Compare the association of individual comorbidities, comorbidity indices, and survival in older adults with non-Hodgkin lymphoma (NHL), including in specific NHL subtypes. METHODS: Data source was SEER-Medicare, a population-based registry of adults age 65 years and older with cancer. We included all incident cases of NHL diagnosed during 2008-2017 who met study inclusion criteria. Comorbidities were classified using the three-factor risk estimate scale (TRES), Charlson comorbidity index (CCI), and National Cancer Institute (NCI) comorbidity index categories and weights. Overall survival (OS) and lymphoma-specific survival, with death from other causes treated as a competing risk, were estimated using the Kaplan-Meier method from time of diagnosis. Multivariable Cox models were constructed, and Harrel C-statistics were used to compare comorbidity models. A two-sided P value of <.05 was considered significant. RESULTS: A total of 40,486 patients with newly diagnosed NHL were included. Patients with aggressive NHL had higher rates of baseline comorbidity. Despite differences in baseline comorbidity between NHL subtypes, cardiovascular, pulmonary, diabetes, and renal comorbidities were frequent and consistently associated with OS in most NHL subtypes. These categories were used to construct a candidate comorbidity score, the non-Hodgkin lymphoma 5 (NHL-5). Comparing three validated comorbidity scores, TRES, CCI, NCI, and the novel NHL-5 score, we found similar associations with OS and lymphoma-specific survival, which was confirmed in sensitivity analyses by NHL subtypes. CONCLUSION: The optimal measure of comorbidity in NHL is unknown. Here, we demonstrate that the three-category TRES and five-category NHL-5 scores perform as well as the 14-16 category CCI and NCI scores in terms of association with OS and lymphoma-specific survival. These simple scores could be more easily used in clinical practice without prognostic loss.
Asunto(s)
Comorbilidad , Linfoma no Hodgkin , Programa de VERF , Humanos , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/mortalidad , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Estados Unidos/epidemiología , Modelos de Riesgos Proporcionales , Pronóstico , Estudios de Cohortes , Estimación de Kaplan-Meier , MedicareRESUMEN
OBJECTIVE: To evaluate the impact of the different types of neoplasms and lineages on mortality of patients with SLE. METHODS: Retrospective and observational comparison of the neoplasm-related deaths in patients with SLE and the general Spanish population reported in the Spanish Hospital Discharge Database. To determine the impact of SLE on the risk of dying from each neoplasm lineage, a binary logistic regression considering age, female sex, tobacco and alcohol consumption, was performed. RESULTS: During 2016-2019, 139 531 in-hospital deaths from neoplasms were certified in Spain (91 in patients with SLE). Patients with SLE presented a lower mortality rate from solid organ neoplasms, (80.2% vs 91.1%, OR 0.393), linked to their lower risk of colorectal carcinoma (1.1% vs 10.8%, OR 0.110). By contrast, gynaecological neoplasms presented a higher risk (8.8% vs 3%, OR 3.039) in the deceased patients with SLE, associated with the higher frequency of vulvar neoplasms (2% vs 0.2%, OR 14.767) and cervical carcinomas (3.3% vs 0.5%, OR 3.809). Haematological neoplasm-related deaths were also more prevalent in patients with SLE (19.8% vs 8.9%, OR 2.546), mostly attributable to the higher proportion of deaths due to non-Hodgkin's lymphoma (11% vs 2.9%, OR 4.060) of B cell lineage (9.9% vs 2.5%, OR 4.133). CONCLUSIONS: Patients with SLE present a higher risk of death from vulvar neoplasms, cervical carcinomas and B-cell non-Hodgkin's lymphoma in comparison with the general Spanish population. In addition to developing strategies that might help to attenuate their occurrence and impact, such as decreasing the immunosuppressive burden, specific early detection programmes for these conditions should be investigated and considered carefully.
Asunto(s)
Carcinoma , Neoplasias de los Genitales Femeninos , Lupus Eritematoso Sistémico , Linfoma no Hodgkin , Femenino , Humanos , Carcinoma/complicaciones , Neoplasias de los Genitales Femeninos/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/epidemiología , Sistema de Registros , Estudios Retrospectivos , MasculinoRESUMEN
BACKGROUND: Certain hazardous air pollutants (HAP) are known or suspected to pose immunological or cancer risk to humans, but evidence is limited from the general population. METHODS: We assessed associations between residential exposure to HAPs at the census tract level and incident non-Hodgkin lymphoma (NHL) and multiple myeloma in the Nurses' Health Study (NHS, 1986-2012) and NHSII (1989-2019). We used the covariate-adjusted proportional hazards model to estimate hazard ratios (HR) of NHL, major NHL subtypes, and multiple myeloma per interquartile range increase in exposure to a given HAP and pooled the cohort-specific estimates using fixed-effects meta-analyses. RESULTS: There were 810 NHL and 158 multiple myeloma cases in NHS (1,700,707 person-years) and 379 NHL and 59 multiple myeloma cases in NHSII (2,820,772 person-years). Most HRs approximated unity. Meta-analyses did not show consistent evidence of associations between any HAP exposure and risk of NHL or multiple myeloma. CONCLUSIONS: Exposure to HAPs was not consistently associated with risks of NHL or multiple myeloma in these nationwide prospective cohorts of women. IMPACT: This is the first nationwide study assessing associations between residential HAP exposures and risk of lymphoid malignances in prospective cohorts and focuses on women, who have frequently been underrepresented in (primarily occupational) studies of exposure to HAPs.
Asunto(s)
Contaminantes Atmosféricos , Exposición a Riesgos Ambientales , Linfoma no Hodgkin , Mieloma Múltiple , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/etiología , Mieloma Múltiple/epidemiología , Mieloma Múltiple/etiología , Estudios Prospectivos , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: To analyze the epidemiology of acute kidney injury (AKI) in children with lymphoma and to assess the incidence, risk profile of AKI, and effects on renal function in children with lymphoma during their first 30 days of hospitalization. MATERIALS AND METHODS: This was a retrospective screen of electronic hospital and laboratory databases to select hospitalized children who were first diagnosed and treated for lymphoma at Beijing Children's Hospital between 2020 and 2021. AKI was defined according to the Kidney Disease Improving Global Outcomes criteria. We analyzed the incidence and risk factors for AKI in children with lymphoma during their first 30 days of hospitalization. We also analyzed mortality rate and the incidence of kidney recovery over a 1-year follow-up period. RESULTS: Of the 295 children with lymphoma (which were all non-Hodgkin lymphoma), 42 (16.5%) experienced AKI events during the first their 30 days of hospitalization. The proportion of patients with lymphoma clinical stage 4 was higher in the AKI group than in the non-AKI group (66.7 vs. 43.7%, p < 0.05). Tumor lysis syndrome (TLS), lung infection, and lymphoma clinical stage were identified as independent risk factors for AKI in children with lymphoma. Severe AKI was associated with TLS, sepsis, and a higher need for intensive care. Over 1-year of follow-up, none of the survivors developed impaired renal function or proteinuria. However, the mortality of children in the AKI group was significantly higher than that in the non-AKI group (p < 0.05). CONCLUSION: TLS, lung infection, and lymphoma clinical stage were identified as independent risk factors for AKI in children with lymphoma during the first 30 days of hospitalization. Clinicians should increase their awareness of AKI in hospitalized patients with lymphoma.
Asunto(s)
Lesión Renal Aguda , Humanos , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/etiología , Lesión Renal Aguda/mortalidad , Lesión Renal Aguda/diagnóstico , Masculino , Femenino , Niño , Estudios Retrospectivos , Factores de Riesgo , Incidencia , Adolescente , Preescolar , Síndrome de Lisis Tumoral/etiología , Síndrome de Lisis Tumoral/complicaciones , Lactante , Hospitalización/estadística & datos numéricos , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/epidemiología , Estadificación de NeoplasiasRESUMEN
BACKGROUND: Non-Hodgkin lymphoma (NHL) accounts for 90% of all malignant lymphomas. This study aimed to evaluate the global incidence, mortality, associated risk factors, and temporal trends of NHL by sex, age, and country. METHODS: Data from 185 countries globally were used for analysis. NHL incidence and mortality were collected via the GLOBOCAN (2020), CI5 series I-X, WHO mortality database, the Nordic Cancer Registries, and the SEER Program. The WHO Global Health Observatory provided country-level, age-standardized prevalence of lifestyle and metabolic risk factors. Trends were examined and reported based on average annual percentage change (AAPC) calculated using Joinpoint regression analysis. Incidence and AAPC are based on data for the last 10 years across countries. RESULTS: Globally, age-standardized incidence and mortality rates for NHL were recorded at 5.8 and 2.6 per 100,000 individuals, respectively. At country-level, NHL incidence was significantly associated with various factors, including HDI (Human Development Index), GDP per capita, prevalence of tobacco and alcohol consumption, sedentary lifestyle, obesity, hypertension, diabetes and hypercholesterolaemia. Rising trend in NHL incidence was observed, with the highest increase recorded in Estonia (AAPCmale = 4.15, AAPCfemale = 5.14), Belarus (AAPCfemale = 5.13), and Lithuania (AAPCfemale = 4.68). While overall NHL mortality has been decreasing, certain populations experienced increased mortality over the decade. In Thailand, AAPC for mortality was 31.28% for males and 30.26% for females. Estonia saw an AAPC of 6.46% for males, while Slovakia experienced an AAPC of 4.24% for females. Colombia's AAPC was 1.29% for males and 1.51% for females. CONCLUSIONS: This study indicates a rising trend of NHL incidence over the past decade- particularly in developed countries, older males, and younger populations. Further research should investigate deeper insights into specific etiology and prognosis of NHL across subtypes, and potential contributors towards these epidemiologic trends.
Asunto(s)
Linfoma no Hodgkin , Linfoma , Humanos , Masculino , Femenino , Linfoma no Hodgkin/epidemiología , Linfoma/epidemiología , Incidencia , Sistema de Registros , Factores de Riesgo , Salud GlobalRESUMEN
BACKGROUND: Acute lymphocytic leukaemia (ALL) and non-Hodgkin lymphoma (NHL) are among the commonest types of childhood cancer. Some previous studies suggested that elevated ultraviolet radiation (UVR) exposures increase ALL risk; many more indicate NHL risk is reduced. METHODS: We assessed age<20 ALL/NHL incidence in Surveillance, Epidemiology and End Results data using AVGLO-derived UVR irradiance/cumulative radiant exposure measures, using quasi-likelihood models accounting for underdispersion, adjusted for age, sex, racial/ethnic group and other county-level socioeconomic variables. RESULTS: There were 30,349 cases of ALL and 8062 of NHL, with significant increasing trends of ALL with UVR irradiance (relative risk (RR) = 1.200/mW/cm2 (95% CI 1.060, 1.359, p = 0.0040)), but significant decreasing trends for NHL (RR = 0.646/mW/cm2 (95% CI 0.512, 0.816, p = 0.0002)). There was a borderline-significant increasing trend of ALL with UVR cumulative radiant exposure (RR = 1.444/MJ/cm2 (95% CI 0.949, 2.197, p = 0.0865)), and significant decreasing trends for NHL (RR = 0.284/MJ/cm2 (95% CI 0.166, 0.485, p < 0.0001)). ALL and NHL trend RR is substantially increased among those aged 0-3. All-age trend RRs are most extreme (increasing for ALL, decreasing for NHL) for Hispanics for both UVR measures. CONCLUSIONS: Our more novel finding, of excess UVR-related ALL risk, is consistent with some previous studies, but is not clear-cut, and in need of replication.
Asunto(s)
Linfoma no Hodgkin , Leucemia-Linfoma Linfoblástico de Células Precursoras , Rayos Ultravioleta , Humanos , Femenino , Niño , Masculino , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/etiología , Preescolar , Rayos Ultravioleta/efectos adversos , Adolescente , Incidencia , Estados Unidos/epidemiología , Lactante , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiología , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiología , Programa de VERF , Luz Solar/efectos adversos , Adulto Joven , Recién Nacido , Neoplasias Inducidas por Radiación/epidemiología , Neoplasias Inducidas por Radiación/etiología , Exposición a la Radiación/efectos adversos , Factores de RiesgoRESUMEN
INTRODUCTION: Lymphoma, encompassing common non-Hodgkin lymphoma (NHL) and less common Hodgkin lymphoma (HL), represents significant hematological malignancies. Advancements in treatment modalities have reshaped survival rates, particularly in NHL. This complexity results in varying outcomes, some requiring extended observation periods and multiple chemotherapy treatments. The primary objective was to explore and compare the overall survival (OS) of HL and NHL at 1, 3, and 5-year follow-ups among adult lymphoma patients in Qatar during January 2013-December 2017. Further objectives encompass comparing the most prevalent histological types, clinical and epidemiological traits of HL and NHL, as well as secondary aims of assessing clinical features, treatment, response, disease-free survival, and OS. METHODS: A retrospective, descriptive study of consecutive cases was conducted at Qatar's NCCCR between 2013 and 2017. Inclusion criteria involved patients ≥18 years old, of any gender and clinical stage at diagnosis, who received chemotherapy and had known outcomes. Descriptive statistics were applied, and survival analysis utilized Kaplan-Meier curves. STATA version 13.0 facilitated data analysis. RESULTS: Between 2013 and 2017, 414 individuals in Qatar were diagnosed with lymphoma. The median age at diagnosis was 49 years (IQR 36-95 years; p < 0.001) across all patients. Males exhibited a higher likelihood of developing HL and NHL, comprising 74% and 70% of cases, respectively, though this difference was statistically insignificant (p = 0.45). Among NHL-B subtypes, mature B-cell neoplasms (60%) predominated, while lymphocyte-rich subtype (49%) was prominent in HL cases. With a median follow-up of 17.3 months, OS rates at 1, 3, and 5 years were 99%, 82%, and 64%, respectively for all lymphoma patients. Subtype stratification revealed trends in 3-year follow-up OS (94 vs. 82%) for HL and NHL, with 5-year OS of 67% and 60%, respectively. HL demonstrated higher OS throughout the study period compared to NHL (p < 0.001), though median OS remained unreached. CONCLUSIONS: Diffuse large B-cell lymphoma emerged as the most prevalent subtype among lymphomas in Qatar. Generally, HL exhibited superior survival rates, at 67% compared to 60% for NHL. Minor deflation in survival rates, particularly for HL, might be attributed to Qatar's immigration patterns.
Asunto(s)
Enfermedad de Hodgkin , Linfoma no Hodgkin , Humanos , Qatar/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Estudios Retrospectivos , Anciano , Enfermedad de Hodgkin/epidemiología , Enfermedad de Hodgkin/mortalidad , Enfermedad de Hodgkin/patología , Anciano de 80 o más Años , Linfoma no Hodgkin/epidemiología , Linfoma no Hodgkin/mortalidad , Linfoma no Hodgkin/patología , Supervivencia sin Enfermedad , Tasa de Supervivencia , Estudios de CohortesRESUMEN
BACKGROUND: This study compared the survival of persons with secondary acute myeloid leukemia (sAML) to those with de novo AML (dnAML) by age at AML diagnosis, chemotherapy receipt, and cancer type preceding sAML diagnosis. METHODS: Data from Surveillance, Epidemiology, and End Results 17 Registries were used, which included 47,704 individuals diagnosed with AML between 2001 and 2018. Multivariable Cox proportional hazards regression was used to compare AML-specific survival between sAML and dnAML. Trends in 5-year age-standardized relative survival were examined via the Joinpoint survival model. RESULTS: Overall, individuals with sAML had an 8% higher risk of dying from AML (hazard ratio [HR], 1.08; 95% confidence interval [CI], 1.05-1.11) compared to those with dnAML. Disparities widened with younger age at diagnosis, particularly in those who received chemotherapy for AML (HR, 1.14; 95% CI, 1.10-1.19). In persons aged 20-64 years and who received chemotherapy, HRs were greatest for those with antecedent myelodysplastic syndrome (HR, 2.04; 95% CI, 1.83-2.28), ovarian cancer (HR, 1.91; 95% CI, 1.19-3.08), head and neck cancer (HR, 1.55; 95% CI, 1.02-2.36), leukemia (HR, 1.45; 95% CI, 1.12-1.89), and non-Hodgkin lymphoma (HR, 1.42; 95% CI, 1.20-1.69). Among those aged ≥65 years and who received chemotherapy, HRs were highest for those with antecedent cervical cancer (HR, 2.42; 95% CI, 1.15-5.10) and myelodysplastic syndrome (HR, 1.28; 95% CI, 1.19-1.38). The 5-year relative survival improved 0.3% per year for sAML slower than 0.86% per year for dnAML. Consequently, the survival gap widened from 7.2% (95% CI, 5.4%-9.0%) during the period 2001-2003 to 14.3% (95% CI, 12.8%-15.8%) during the period 2012-2014. CONCLUSIONS: Significant survival disparities exist between sAML and dnAML on the basis of age at diagnosis, chemotherapy receipt, and antecedent cancer, which highlights opportunities to improve outcomes among those diagnosed with sAML.