Non-Hodgkin lymphoma is one of the most common cancers diagnosed in the United States, accounting for nearly 4% of all cancers. This year, about 81,600 individuals will be diagnosed with non-Hodgkin lymphoma, and nearly 21,000 will die from the cancer.

A study by Ocier et al published in Cancer Epidemiology, Biomarkers & Prevention investigating the incidence of age-related diseases among younger vs older B-cell non-Hodgkin lymphoma survivors compared with their respective general population cohorts has found that survivors younger than age 65 had higher relative risks of developing acute renal failure, pneumonia, and nutritional deficiencies than their older counterparts at 5 or more years after their cancer diagnosis. The study’s findings may provide opportunities for the screening and management of acute and chronic health conditions in these survivors.

Study Methodology

The researchers analyzed data from 2,129 B-cell non-Hodgkin lymphoma survivors diagnosed between 1997 and 2015 from the Utah Cancer Registry. Using the Utah Population Database, the researchers matched up to five cancer-free individuals from the general population (8,969 in total) with each B-cell non-Hodgkin lymphoma survivor based on sex, age, and state of birth.

Age-related disease outcomes were identified from Intermountain Healthcare and University of Utah medical records, along with statewide health-care facility data. Hazard ratios (HRs) were estimated using Cox proportional hazards models for B-cell non-Hodgkin lymphoma survivors diagnosed at < 65 years vs ≥ 65 years at least 5 years after their B-cell non-Hodgkin lymphoma diagnosis.

Results

The researchers compared the 2,129 survivors with 8,969 individuals from the general population. Younger B-cell non-Hodgkin lymphoma survivors had higher relative risks for acute renal failure (HR = 2.24, 99% confidence interval [CI] = 1.48–3.39, P = .017), pneumonia (HR = 2.42, 99% CI = 1.68–3.49, P = .055), and nutritional deficiencies (HR = 2.08, 99% CI = 1.48–2.92, P = .051) ≥ 5 years after cancer diagnosis.

Compared with the general population, the risk of acute renal failure was increased 2.24-fold in younger survivors and 1.13-fold in older survivors; the risk of pneumonia was increased 2.42-fold in younger survivors and 1.44-fold in older survivors; and the risk of nutritional deficiencies was increased 2.08-fold in younger survivors and 1.25-fold in older survivors.

“This study demonstrates that more research is warranted that differentiates risks between younger and older B-cell non-Hodgkin lymphoma survivors to corroborate elevated long-term disease risks attributed to rigorous cancer treatment regimens among younger B-cell non-Hodgkin lymphoma survivors,” concluded the study authors.

Key Takeaways

According to the study, although younger B-cell non-Hodgkin lymphoma survivors had healthier demographic profiles, such as normal body mass index at baseline, they were more likely to be diagnosed with regional/distant disease; to receive first-line treatment and undergo hematopoietic cell transplantation; and to be diagnosed with aggressive disease subtypes, including diffuse large B-cell lymphoma, compared with older survivors in the study cohort. According to the study authors, this suggests that a B-cell non-Hodgkin lymphoma diagnosis and the related treatment regimens younger survivors were likely to undergo may be strongly associated with specific disease risks compared with their older counterparts.

“A key takeaway of this study is that earlier onset of age-related diseases is likely to occur among younger non-Hodgkin lymphoma survivors. Therefore, periodic screening for a range of health outcomes and standardized care targeting these outcomes may be beneficial,” said Krista Ocier, PhD, MPH, a postdoctoral researcher in the Hashibe lab at the University of Utah Huntsman Cancer Institute and the first author of this study, in a statement. “Our results also support the possible need for nutritional intervention during and after cancer treatment because nutritional deficiencies may impact the overall quality of life of B-cell non-Hodgkin lymphoma survivors, especially the younger ones as they age.”

Mia Hashibe, PhD, of the Huntsman Cancer Institute, is the corresponding author for the Cancer Epidemiology, Biomarkers & Prevention article.

Disclosure: Funding for this study was provided by the National Institutes of Health, the Huntsman Cancer Institute, the Utah Cancer Registry, the Center for Disease Control and Prevention’s National Program of Cancer Registries, the University of Utah, and the Huntsman Cancer Foundation. For full disclosures of the study authors, visit cebp.aacrjournals.org.