A national study on conditional survival, excess mortality and second cancer after high dose therapy with autologous stem cell transplantation for non-Hodgkin lymphoma

被引:25
作者
Smeland, Knut B. [1 ,2 ]
Kiserud, Cecilie E. [1 ]
Lauritzsen, Grete F. [3 ]
Blystad, Anne K. [3 ]
Fagerli, Unn-Merete [4 ,5 ]
Falk, Ragnhild S. [6 ]
Fluge, Oystein [7 ]
Fossa, Alexander [3 ]
Kolstad, Arne [3 ]
Loge, Jon H. [1 ,8 ]
Maisenholder, Martin [9 ]
Ostenstad, Bjorn [3 ]
Kvaloy, Stein [2 ,10 ]
Holte, Harald [3 ]
机构
[1] Oslo Univ Hosp, Dept Oncol, Natl Advisory Unit Late Effects, POB 4953, NO-0424 Oslo, Norway
[2] Univ Oslo, Fac Med, N-0316 Oslo, Norway
[3] Oslo Univ Hosp, Dept Oncol, POB 4953, NO-0424 Oslo, Norway
[4] St Olavs Hosp, Dept Oncol, Oslo, Norway
[5] Norwegian Univ Sci & Technol, Dept Canc Res & Mol Med, N-7034 Trondheim, Norway
[6] Oslo Univ Hosp, Res Support Serv, Oslo Ctr Biostat & Epidemiol, POB 4953, NO-0424 Oslo, Norway
[7] Haukeland Hosp, Dept Oncol & Med Phys, N-5021 Bergen, Norway
[8] Univ Oslo, Fac Med, Dept Behav Sci Med, Oslo, Norway
[9] Univ Hosp North Norway, Dept Oncol, Tromso, Norway
[10] Oslo Univ Hosp Oslo, Div Canc Med Surg & Transplantat, Oslo, Norway
关键词
NHL; autologous stem cell transplantation; conditional survival; SMR; lymphoma; BONE-MARROW TRANSPLANT; HEMATOPOIETIC SCT; RISK; RITUXIMAB; OUTCOMES; IMPACT; MALIGNANCIES; MULTICENTER; NORWAY; TRIAL;
D O I
10.1111/bjh.13965
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This national population-based study aimed to investigate conditional survival and standardized mortality ratios (SMR) after high-dose therapy with autologous stem-cell transplantation (HDT-ASCT) for non-Hodgkin lymphoma (NHL), and to analyse cause of death, relapses and second malignancies. All patients >= 18 years treated with HDT-ASCT for NHL in Norway between 1987 and 2008 were included (n = 578). Information from the Cause of Death Registry and Cancer Registry of Norway were linked with clinical data. The 5-, 10- and 20-year overall survival was 61% (95% confidence interval [CI] 56-64%), 52% (95% CI 48-56%) and 45% (95% CI 40-50%), respectively. The 5-year survival conditional on having survived 2, 5 and 10 years after HDT-ASCT was 81%, 86% and 93%. SMRs were 12.3 (95% CI 11.0-13.9), 4.9 (95% CI 4.1-5.9), 2.4 (95% CI 1.8-3.2) and 1.0 (95% CI 0.6-1.8) for the entire cohort and for patients having survived 2, 5 and 10 years after HDT-ASCT respectively. Of the 281 deaths observed, 77% were relapse-related. Treatment-related mortality was 3.6%. The 10-year cumulative incidence of second malignancies was 7.9% and standardized incidence ratio was 2.0 (95% CI 1.5-2.6). NHL patients treated with HDT-ASCT were at increased risk of second cancer and premature death. The mortality was still elevated at 5 years, but after 10 years mortality equalled that of the general population.
引用
收藏
页码:432 / 443
页数:12
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