Risk Factors for Cancer-specific Mortality and Cardiovascular Mortality in Patients With Diffuse Large B-cell Lymphoma


Clin Lymphoma Myeloma Leuk. 2020 Jun 14:S2152-2650(20)30303-7. doi: 10.1016/j.clml.2020.06.005. Online ahead of print.


BACKGROUND: The purpose of this study was to assess the risk factors for cancer-specific mortality and cardiovascular mortality in patients with diffuse large B-cell lymphoma (DLBCL).

PATIENTS AND METHODS: A retrospective cohort study involving patients with DLBCL who were registered in the Surveillance, Epidemiology, and End Results (SEER) database was performed. The risk factors for cancer-specific mortality and cardiovascular mortality were analyzed using the competing risk regression model.

RESULTS: A total of 62,950 patients with DLBCL were enrolled, of which 23,302 (37.50%) died of cancer and 2940 (4.70%) died of cardiovascular disease. The competing risk multivariate analysis displayed that age at diagnosis (hazard ratio [HR], 1.033; 95% confidence interval [CI], 1.032-1.034), marriedstatus (HR, 1.293; 95% CI, 1.241-1.347), black race (HR, 1.079; 95% CI, 1.021-1.139), and tumor stage (II: HR, 1.143; 95%CI, 1.095-1.192; III: HR, 1.459; 95% CI, 1.395-1.526; IV: HR, 1.961; 95% CI. 1.889-2.035) were the risk factors for cancer-specific mortality, but not female gender (HR, 0.938; 95% CI, 0.913,0.965) or treatment modalities (chemotherapy: HR, 0.522; 95% CI, 0.505-0.540; radiotherapy: HR, 0.782; 95% CI, 0.728-0.839; chemotherapy + radiotherapy: HR, 0.422; 95% CI, 0.403-0.441). Age at diagnosis (HR, 1.059; 95% CI, 1.055-1.062) and black race (HR, 1.246; 95% CI, 1.067-1.456) were the risk factors for cardiovascular mortality rather than female gender (HR, 0.803; 95% CI, 0.743-0.867) and married status (HR, 0.841; 95% CI, 0.745-0.950).

CONCLUSIONS: Age at diagnosis, married status, black race, and higher tumor stage are associated with an increased risk of cancer-specific mortality in patients with DLBCL, whereas age at diagnosis and black race are associated with a higher risk of cardiovascular mortality.