| 1. |
- Melén, Christopher M., et al.
(författare)
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Chemotherapeutic intensity and survival differences in young patients with diffuse large B-cell lymphoma : a Swedish Lymphoma Registry study
- 2016
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 175:4, s. 614-622
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Tidskriftsartikel (refereegranskat)abstract
- Young patients with diffuse large B-cell lymphoma (DLBCL) are variably treated with rituximab combined with cyclophosphamide-doxorubicin-vincristine-prednisone (R-CHOP), CHOP-etoposide (R-CHOEP), and anthracycline-based regimens with the addition of high-dose cytarabine/methotrexate (R-HDA/M). Using the nationwide, population-based Swedish Lymphoma Registry, we evaluated outcome, by treatment and Healthcare Region, in all 751 DLBCL patients aged 60years without central nervous involvement, diagnosed in Sweden between 2007 and 2012. Overall survival was estimated using multivariate Cox analysis. In patients with age-adjusted international prognostic index (aaIPI)2, the 5-year overall survival (OS) was 70%, 76% and 85% after R-CHOP, R-CHOEP and R-HDA/M, respectively (P=0002); the corresponding estimates were 40%, 55%, and 92% in aaIPI=3 (P=0014). There were large therapeutic differences between Sweden's six Healthcare Regions for aaIPI2: three were Moderate (more R-CHOP) and three Intensive (more R-CHOEP and R-HDA/M). Patients with aaIPI2 who were treated in the Intensive Regions, showed better OS (P<000005), particularly those with aaIPI=3 (5-year OS, 62% vs. 30%; P<000005). There were no regional differences in therapy or survival in patients with aaIPI<2. We conclude that in younger high-risk patients, survival appears superior after more intensive therapy than R-CHOP.
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| 2. |
- Molin, Daniel, 1969-, et al.
(författare)
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Nodular lymphocyte predominant Hodgkin lymphoma in Sweden between 2000 and 2014 : an analysis of the Swedish Lymphoma Registry
- 2017
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Ingår i: British Journal of Haematology. - : WILEY. - 0007-1048 .- 1365-2141. ; 177:3, s. 449-456
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Tidskriftsartikel (refereegranskat)abstract
- Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is an indolent CD20(+) lymphoma. Its scarcity has made clinical trials difficult and there is no consensus on first-line treatment. We conducted a population-based study of all patients diagnosed with NLPHL in Sweden between 2000 and 2014 (N=158; 41 women and 117 men), focusing on clinical features, therapy and overall survival. The median female and male age was 59 and 44years, respectively (P=0002). In early-stage disease, there was little mortality and no survival differences between therapies. In patients with advanced-stage disease, mortality was relatively high in patients who did not receive first-line rituximab but absent in those who did (10-year survival, 55% vs. 100%; P=0033); there were no imbalances of prognostic factors between those two groups. In advanced stages, first-line rituximab use increased markedly between 2000-2004 and 2005-2014 (7% vs. 67%; P<000005), as did 10-year survival, 53% vs. 72% (multivariate P=0027). Although all patients were diagnosed in the 2000s, this is the longest-followed (and largest) population-based cohort. We report a hitherto unreported 15-year median age difference between sexes, increasing rituximab use and improved survival.
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