Department of Immunology, Genetics and Pathology, Cancer Precision Medicine, Uppsala University and Uppsala Akademiska Hospital, Uppsala, Sweden.
Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.
Blood Adv. 2023 Mar 14;7(5):866-874. doi: 10.1182/bloodadvances.2022007241.
Studies on late effects in patients with mantle cell lymphoma (MCL) are becoming increasingly important as survival is improving, and novel targeted drugs are being introduced. However, knowledge about late effects is limited. The aim of this population-based study was to describe the magnitude and panorama of late effects among patients treated with or without high-dose chemotherapy with autologous stem cell transplantation (HD-ASCT). The study cohort included all patients with MCL, recorded in the Swedish Lymphoma Register, aged 18 to 69 years, diagnosed between 2000 and 2014 (N = 620; treated with HD-ASCT, n = 247) and 1:10 matched healthy comparators. Patients and comparators were followed up via the National Patient Register and Cause of Death Register, from 12 months after diagnosis or matching to December 2017. Incidence rate ratios of the numbers of outpatient visits, hospitalizations, and bed days were estimated using negative binomial regression models. In relation to the matched comparators, the rate of specialist and hospital visits was significantly higher among patients with MCL. Patients with MCL had especially high relative risks of infectious, respiratory, and blood disorders. Within this observation period, no difference in the rate of these complications, including secondary neoplasms, was observed between patients treated with and without HD-ASCT. Most of the patients died from their lymphoma and not from another cause or treatment complication. Taken together, our results imply that most of the posttreatment health care needs are related to the lymphoma disease itself, thus, indicating the need for more efficient treatment options.
随着生存状况的改善和新型靶向药物的引入，对套细胞淋巴瘤（MCL）患者晚期效应的研究变得越来越重要。然而，人们对晚期效应的认识有限。本基于人群的研究旨在描述接受或未接受大剂量化疗联合自体造血干细胞移植（HD-ASCT）治疗的患者的晚期效应的严重程度和全景。该研究队列包括所有记录在瑞典淋巴瘤登记处、年龄在 18 至 69 岁之间、2000 年至 2014 年间诊断为 MCL 的患者（n = 620；接受 HD-ASCT 治疗，n = 247），并按照 1:10 比例匹配健康对照者。患者和对照者从诊断后或匹配后 12 个月开始，通过国家患者登记处和死因登记处进行随访，直至 2017 年 12 月。采用负二项回归模型估计门诊就诊、住院和卧床天数的发病率比值。与匹配的对照者相比，MCL 患者的专科和医院就诊率明显更高。MCL 患者特别容易发生感染、呼吸系统和血液系统疾病。在这个观察期内，未观察到接受和未接受 HD-ASCT 治疗的患者之间这些并发症（包括继发性肿瘤）的发生率存在差异。大多数患者死于淋巴瘤，而不是死于其他原因或治疗并发症。总之，我们的研究结果表明，大多数治疗后医疗保健需求与淋巴瘤疾病本身有关，因此，这表明需要更有效的治疗方案。
