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Impact of comorbidity on survival in peripheral T-cell lymphomas : A Swedish Lymphoma Registry study

Ellin, Fredrik LU ; Jerkeman, Mats LU ; Törnqvist, Jenny; Brudin, Lars and Relander, Thomas LU (2017) In Hematological Oncology
Abstract

Comorbidity impacts survival in B-cell lymphoma patients, but the influence in peripheral T-cell lymphomas (PTCLs) has been little studied. To investigate the impact of comorbidity on outcome in PTCL, we identified adult patients with newly diagnosed PTCL from 2000 to 2009 in the Swedish Lymphoma Registry. Data on comorbidity at diagnosis were retrospectively collected according to the Charlson Comorbidity Index (CCI). Comorbid conditions were present in 263 out of 694 (38%) patients. A CCI score of ≥2 was associated with inferior overall survival (OS) (hazard ratio [HR] 1.63, P < .001) and progression-free survival (HR 1.54, P < .001) in multivariate analysis. In patients undergoing front-line autologous stem cell transplantation... (More)

Comorbidity impacts survival in B-cell lymphoma patients, but the influence in peripheral T-cell lymphomas (PTCLs) has been little studied. To investigate the impact of comorbidity on outcome in PTCL, we identified adult patients with newly diagnosed PTCL from 2000 to 2009 in the Swedish Lymphoma Registry. Data on comorbidity at diagnosis were retrospectively collected according to the Charlson Comorbidity Index (CCI). Comorbid conditions were present in 263 out of 694 (38%) patients. A CCI score of ≥2 was associated with inferior overall survival (OS) (hazard ratio [HR] 1.63, P < .001) and progression-free survival (HR 1.54, P < .001) in multivariate analysis. In patients undergoing front-line autologous stem cell transplantation (auto SCT), CCI >0 was associated with inferior OS (HR 2.40, P = .013). Chemotherapy regimens were classified as curative or low-intensity treatments. Among patients aged ≥75 years (n = 214), low-intensity and curative treatment groups had similar OS (HR 0.8, P = .6), also when adjusted for CCI. In summary, our results demonstrate CCI to be independently associated with survival in PTCLs. Even limited comorbidity impacted survival after front-line auto SCT, which needs to be considered in treatment decisions. Intensive anthracycline-based chemotherapy in elderly PTCL patients might be of limited benefit.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Autologous stem cell transplantation, Comorbidity, Elderly, Peripheral T-cell lymphoma, Treatment
in
Hematological Oncology
publisher
John Wiley and Sons Ltd
external identifiers
  • scopus:85018758548
ISSN
0278-0232
DOI
10.1002/hon.2428
language
English
LU publication?
yes
id
4b189548-d65f-4351-98b6-b447d9f68b30
date added to LUP
2017-06-01 14:01:40
date last changed
2017-06-02 03:00:02
@article{4b189548-d65f-4351-98b6-b447d9f68b30,
  abstract     = {<p>Comorbidity impacts survival in B-cell lymphoma patients, but the influence in peripheral T-cell lymphomas (PTCLs) has been little studied. To investigate the impact of comorbidity on outcome in PTCL, we identified adult patients with newly diagnosed PTCL from 2000 to 2009 in the Swedish Lymphoma Registry. Data on comorbidity at diagnosis were retrospectively collected according to the Charlson Comorbidity Index (CCI). Comorbid conditions were present in 263 out of 694 (38%) patients. A CCI score of ≥2 was associated with inferior overall survival (OS) (hazard ratio [HR] 1.63, P &lt; .001) and progression-free survival (HR 1.54, P &lt; .001) in multivariate analysis. In patients undergoing front-line autologous stem cell transplantation (auto SCT), CCI &gt;0 was associated with inferior OS (HR 2.40, P = .013). Chemotherapy regimens were classified as curative or low-intensity treatments. Among patients aged ≥75 years (n = 214), low-intensity and curative treatment groups had similar OS (HR 0.8, P = .6), also when adjusted for CCI. In summary, our results demonstrate CCI to be independently associated with survival in PTCLs. Even limited comorbidity impacted survival after front-line auto SCT, which needs to be considered in treatment decisions. Intensive anthracycline-based chemotherapy in elderly PTCL patients might be of limited benefit.</p>},
  author       = {Ellin, Fredrik and Jerkeman, Mats and Törnqvist, Jenny and Brudin, Lars and Relander, Thomas},
  issn         = {0278-0232},
  keyword      = {Autologous stem cell transplantation,Comorbidity,Elderly,Peripheral T-cell lymphoma,Treatment},
  language     = {eng},
  month        = {05},
  publisher    = {John Wiley and Sons Ltd},
  series       = {Hematological Oncology},
  title        = {Impact of comorbidity on survival in peripheral T-cell lymphomas : A Swedish Lymphoma Registry study},
  url          = {http://dx.doi.org/10.1002/hon.2428},
  year         = {2017},
}