Chronic medical conditions and late effects following non‐Hodgkin lymphoma in HIV‐uninfected and HIV‐infected adolescents and young adults: a population‐based study. (20th February 2020)

• Record Type: Journal Article
• Authors: Abrahão, Renata; Li, Qian W.; Malogolowkin, Marcio H.; Alvarez, Elysia M.; Ribeiro, Raul C.; Wun, Ted; Keegan, Theresa H. M.
• Is Part Of: British journal of haematology. Volume 190:Number 3(2020)
• Page Start: 371
• Page End: 384
• Publication Date: 2020-02-20
• Subjects: non‐Hodgkin lymphoma -- late effects -- adolescent and young adult -- population‐based study; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.16539
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: Little is known about the incidence of late effects following non‐Hodgkin lymphoma (NHL) among adolescent and young adult (AYA, 15–39 years) survivors. Using data from the California Cancer Registry linked to hospital discharge, we estimated the cumulative incidence of late effects at 10 years among AYAs diagnosed with NHL during 1996–2012, who survived ≥2 years. Cox proportional‐hazards models were used to investigate the influence of sociodemographic and clinical factors on the occurrence of late effects. Of 4392 HIV‐uninfected patients, the highest incident diseases were: endocrine (18·5%), cardiovascular (11·7%), and respiratory (5·0%), followed by secondary primary malignancy (SPM, 2·6%), renal and neurologic (2·2%), liver/pancreatic (2·0%), and avascular necrosis (1·2%). Among the 425 HIV‐infected survivors, incidence was higher for all late effects, especially over threefold increased risk of SPM, compared to HIV‐uninfected patients (8·1% vs. 2·6%). In multivariable models for HIV‐uninfected patients, public or no health insurance (vs. private), residence in lower socioeconomic neighbourhoods (vs. higher), and receipt of a haematopoietic stem cell transplant were associated with a greater risk of most late effects. Our findings of substantial incidence of late effects among NHL AYA survivors emphasise the need for longterm follow‐up and appropriate survivorship care to reduce morbidity and mortality in this vulnerable population.