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21 世纪早期接受化疗的弥漫性大 B 细胞淋巴瘤人群队列的病因特异性死亡率。

Cause-specific mortality in a population-level cohort of diffuse large B-cell lymphoma following chemotherapy in the early 21st century.

机构信息

Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.

Key Laboratory of Hematology of Nanjing Medical University, Nanjing, 210029, China.

出版信息

Ann Hematol. 2024 May;103(5):1675-1685. doi: 10.1007/s00277-024-05619-w. Epub 2024 Jan 16.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is a severe non-Hodgkin's lymphoma. Life expectancy has improved with rituximab, but cause-specific mortality data is lacking. Using the Surveillance, Epidemiology, and End Results (SEER) database to study 27,449 individuals aged 20-74 years diagnosed with primary DLBCL who received chemotherapy between 2000 and 2019, we calculated standardized mortality rate (SMR) and excess absolute risk (EAR) and examined the connection between age, sex, time after diagnosis, and cause of death. Based on 12,205 deaths, 68.7% were due to lymphoma, 20.1% non-cancer causes, and 11.2% other cancers. Non-cancer mortality rates (SMR 1.2; EAR, 21.5) increased with DLBCL compared to the general population. The leading non-cancer death causes were cardiovascular (EAR, 22.6; SMR, 1.6) and infectious (EAR, 9.0; SMR, 2.9) diseases with DLBCL. Risks for non-cancer death and solid neoplasms are highest within the first diagnosis year, then decrease. Among socioeconomic factors, being white, being married, and having a higher income were favorable factors for reducing non-cancer mortality. To improve survival, close surveillance, assessment of risk factors, and early intervention are needed.

摘要

弥漫性大 B 细胞淋巴瘤(DLBCL)是一种严重的非霍奇金淋巴瘤。随着利妥昔单抗的应用,患者的预期寿命得到了改善,但缺乏特异性死亡率数据。本研究利用监测、流行病学和最终结果(SEER)数据库,对 2000 年至 2019 年期间接受化疗的 27449 名年龄在 20-74 岁的原发性 DLBCL 患者进行了研究,计算了标准化死亡率(SMR)和超额绝对风险(EAR),并探讨了年龄、性别、诊断后时间和死亡原因之间的关系。基于 12205 例死亡,68.7%归因于淋巴瘤,20.1%归因于非癌症原因,11.2%归因于其他癌症。与普通人群相比,非癌症死亡率(SMR 1.2;EAR,21.5)随着 DLBCL 而增加。非癌症死亡的主要原因是心血管疾病(EAR,22.6;SMR,1.6)和感染性疾病(EAR,9.0;SMR,2.9),这些疾病与 DLBCL 相关。非癌症死亡和实体肿瘤的风险在首次诊断年内最高,然后降低。在社会经济因素中,白人、已婚和高收入是降低非癌症死亡率的有利因素。为了提高生存率,需要进行密切监测、评估风险因素和早期干预。

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