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Survival patterns in patients with Hodgkin's lymphoma with a pre-existing hospital discharge diagnosis of autoimmune disease.

Abstract

PURPOSE

Autoimmune diseases (AIs) are associated with elevated risk for Hodgkin's lymphoma (HL); however, information on the interplay of AIs and HL on survival is sparse.

PATIENTS AND METHODS

We evaluated survival patterns for 7,414 patients with HL in relation to a pre-existing hospital discharge diagnosis of an AI. We also assessed survival patterns in relation to a prior AI diagnosis among 29,240 population-based matched controls.

RESULTS

Among female patients with HL with (v those without) a pre-existing AI, the 5-year and 10-year overall survival was 46.0% (63.3%) and 41.0% (51.9%); for males, the corresponding numbers were 48.5% (59.2%) and 43.6% (51.5%), respectively (P < .001). Among female controls with (v those without) a pre-existing AI, the 5-year and 10-year overall survival was 79.1% (90.2%) and 67.2% (83.3%); for males, the corresponding numbers were 82.5% (90.3%) and 68.6% (81.6%), respectively (P < .001). Female patients with HL with (v those without) a pre-existing AI had a 1.8-fold (range, 1.3- to 2.4-fold) increased relative risk of dying at 5 years of follow-up; for males, the corresponding excess relative risk of dying was 1.7-fold (range, 1.3- to 2.2-fold).

CONCLUSION

Patients with HL have an overall excellent outcome from treatment but also pose some of the most complex challenges of cancer survivorship due to many late effects (eg, second malignancies, thyroid disease, cardiovascular disease, and altered reproductive and sexual function). Our finding that patients with HL with a hospital discharge diagnosis of an AI have a substantially higher risk of dying, emphasizes that underlying chronic diseases, such as AIs, should be high of the list of survivorship concerns for clinicians that treat HL.

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  • Authors+Show Affiliations

    ,

    Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. landgreo@mail.nih.gov

    , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Autoimmune Diseases
    Child
    Child, Preschool
    Female
    Hodgkin Disease
    Humans
    Kaplan-Meier Estimate
    Male
    Middle Aged
    Proportional Hazards Models
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Intramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20940191

    Citation

    Landgren, Ola, et al. "Survival Patterns in Patients With Hodgkin's Lymphoma With a Pre-existing Hospital Discharge Diagnosis of Autoimmune Disease." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 28, no. 34, 2010, pp. 5081-7.
    Landgren O, Pfeiffer RM, Kristinsson SY, et al. Survival patterns in patients with Hodgkin's lymphoma with a pre-existing hospital discharge diagnosis of autoimmune disease. J Clin Oncol. 2010;28(34):5081-7.
    Landgren, O., Pfeiffer, R. M., Kristinsson, S. Y., & Björkholm, M. (2010). Survival patterns in patients with Hodgkin's lymphoma with a pre-existing hospital discharge diagnosis of autoimmune disease. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 28(34), pp. 5081-7. doi:10.1200/JCO.2010.29.2243.
    Landgren O, et al. Survival Patterns in Patients With Hodgkin's Lymphoma With a Pre-existing Hospital Discharge Diagnosis of Autoimmune Disease. J Clin Oncol. 2010 Dec 1;28(34):5081-7. PubMed PMID: 20940191.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Survival patterns in patients with Hodgkin's lymphoma with a pre-existing hospital discharge diagnosis of autoimmune disease. AU - Landgren,Ola, AU - Pfeiffer,Ruth M, AU - Kristinsson,Sigurdur Y, AU - Björkholm,Magnus, Y1 - 2010/10/12/ PY - 2010/10/14/entrez PY - 2010/10/14/pubmed PY - 2011/1/5/medline SP - 5081 EP - 7 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 28 IS - 34 N2 - PURPOSE: Autoimmune diseases (AIs) are associated with elevated risk for Hodgkin's lymphoma (HL); however, information on the interplay of AIs and HL on survival is sparse. PATIENTS AND METHODS: We evaluated survival patterns for 7,414 patients with HL in relation to a pre-existing hospital discharge diagnosis of an AI. We also assessed survival patterns in relation to a prior AI diagnosis among 29,240 population-based matched controls. RESULTS: Among female patients with HL with (v those without) a pre-existing AI, the 5-year and 10-year overall survival was 46.0% (63.3%) and 41.0% (51.9%); for males, the corresponding numbers were 48.5% (59.2%) and 43.6% (51.5%), respectively (P < .001). Among female controls with (v those without) a pre-existing AI, the 5-year and 10-year overall survival was 79.1% (90.2%) and 67.2% (83.3%); for males, the corresponding numbers were 82.5% (90.3%) and 68.6% (81.6%), respectively (P < .001). Female patients with HL with (v those without) a pre-existing AI had a 1.8-fold (range, 1.3- to 2.4-fold) increased relative risk of dying at 5 years of follow-up; for males, the corresponding excess relative risk of dying was 1.7-fold (range, 1.3- to 2.2-fold). CONCLUSION: Patients with HL have an overall excellent outcome from treatment but also pose some of the most complex challenges of cancer survivorship due to many late effects (eg, second malignancies, thyroid disease, cardiovascular disease, and altered reproductive and sexual function). Our finding that patients with HL with a hospital discharge diagnosis of an AI have a substantially higher risk of dying, emphasizes that underlying chronic diseases, such as AIs, should be high of the list of survivorship concerns for clinicians that treat HL. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/20940191/full_citation L2 - http://ascopubs.org/doi/full/10.1200/JCO.2010.29.2243?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -