Unmarried or less-educated patients with mantle cell lymphoma are less likely to undergo a transplant, leading to lower survival

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Glimelius, Ingrid,1975-Uppsala universitet,Karolinska Institutet,Uppsala University,Karolinska Institute,Uppsala University Hospital,Experimentell och klinisk onkologi,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden. (author)

Unmarried or less-educated patients with mantle cell lymphoma are less likely to undergo a transplant, leading to lower survival

Article/chapterEnglish2021

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2021-03-12
American Society of Hematology,2021
10 s.

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LIBRIS-ID:oai:lup.lub.lu.se:d04000ca-ff14-4e4d-b2c4-9454c2c3caf8
https://lup.lub.lu.se/record/d04000ca-ff14-4e4d-b2c4-9454c2c3caf8URI
https://doi.org/10.1182/bloodadvances.2020003645DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:146291724URI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-441970URI

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Language:English
Summary in:English

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It is unknown how many mantle cell lymphoma (MCL) patients undergo consolidation with autologous hematopoietic cell transplantation (AHCT), and the reasons governing the decision, are also unknown. The prognostic impact of omitting AHCT is also understudied. We identified all MCL patients diagnosed from 2000 to 2014, aged 18 to 65 years, in the Swedish Lymphoma Register. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression models were used to compare the likelihood of AHCT within 18 months of diagnosis. All-cause mortality was compared between patients treated with/without AHCT using hazard ratios (HRs) and 95% CIs estimated from Cox regression models. Probabilities of being in each of the following states: alive without AHCT, alive with AHCT, dead before AHCT, and dead after AHCT, were estimated over time from an illness-death model. Among 369 patients, 148 (40%) were not treated with AHCT within 18 months. Compared with married patients, never married and divorced patients had lower likelihood of undergoing AHCT, as had patients with lower educational level, and comorbid patients. Receiving AHCT was associated with reduced all-cause mortality (HR 5 0.58, 95% CI: 0.40-0.85). Transplantation-related mortality was low (2%). MCL patients not receiving an AHCT had an increased mortality rate, and furthermore, an undue concern about performing an AHCT in certain societal groups was seen. Improvements in supportive functions potentially increasing the likelihood of tolerating an AHCT and introduction of more tolerable treatments for these groups are needed.

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Smedby, Karin E.Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.;Karolinska Inst, Karolinska Univ Hosp, Dept Med Solna, Div Hematol, Stockholm, Sweden. (author)
Albertsson-Lindblad, AlexandraLund University,Lunds universitet,Lymfom - Klinisk forskning,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Lymphoma - Clinical Research,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Oncol, Lund, Sweden.(Swepub:lu)med-aab (author)
Crowther, Michael J.Karolinska Institutet,Karolinska Institute,University of Leicester,Univ Leicester, Dept Hlth Sci, Biostat Res Grp, Leicester, Leics, England.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden. (author)
Eloranta, SandraKarolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden. (author)
Jerkeman, MatsLund University,Lunds universitet,Lymfom - Klinisk forskning,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Lymphoma - Clinical Research,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Oncol, Lund, Sweden.(Swepub:lu)onk-mje (author)
Weibull, Caroline E.Karolinska Institutet,Karolinska Institute,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden. (author)
Uppsala UniversityKarolinska Institute (creator_code:org_t)

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In:Blood Advances: American Society of Hematology5:6, s. 1638-16472473-95292473-9537

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