Comorbidities and sex differences in causes of death among mantle cell lymphoma patients - A nationwide population-based cohort study.
The prognosis for mantle cell lymphoma (MCL) remains poor. Our aim was to assess the impact of comorbidities on survival and causes of death. For 1,385 MCL patients (1,009 males, 376 females) diagnosed in 2000-2014 (median age 71 years, range 22-96) comorbidities ≤ 10 years of diagnosis were classified according to the Charlson comorbidity index (CCI; 0, 1, 2+). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to compare lymphoma-specific and all-cause mortality rates. Model-based predictions were used to obtain probabilities of death. Overall, 44% had any comorbidity (CCI 1+) and 28% severe comorbidity (CCI 2+). Over a median follow-up of 3·7 years (range 0-16), 633 (46%) died, the majority (76%) from lymphoma. Severe comorbidity was independently associated with higher all-cause [hazard ratio (HR) = 1·52; 95% CI: 1·24-1·85) and lymphoma-specific mortality (HR = 1·31; 95% CI: 1·04-1·65). Particularly among patients with connective tissue, renal and psychiatric diseases, and dementia. Among females with any comorbidity, non-lymphoma deaths represented a larger proportion of all deaths, compared to males with any comorbidity. In general, more efficient lymphoma treatments need to be considered also for patients with severe comorbidity. However, among females with any comorbidity, the likelihood of non-lymphoma death was still considerable, perhaps favouring a more liberal use of a "wait and watch" approach.
['Glimelius|Ingrid|I|0000-0001-6158-3041', 'Smedby|Karin E|KE|', 'Eloranta|Sandra|S|0000-0001-5806-0573', 'Jerkeman|Mats|M|', 'Weibull|Caroline E|CE|0000-0001-8231-8183']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D018572:Disease-Free Survival D005260:Female D005500:Follow-Up Studies D006801:Humans D020522:Lymphoma, Mantle-Cell D008297:Male D008875:Middle Aged D008954:Models, Biological D012042:Registries D012727:Sex Characteristics D015996:Survival Rate
comorbidity sex cause of death mantle cell lymphoma lymphoma-specific mortality