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Chronic medical conditions and late effects following non-Hodgkin lymphoma in HIV-uninfected and HIV-infected adolescents and young adults: a population-based study.

HIV 未感染和 HIV 感染的青少年和年轻人非霍奇金淋巴瘤后的慢性疾病和晚期效应: 一项基于人群的研究。

  • 影响因子:3.39
  • DOI:10.1111/bjh.16539
  • 作者列表:"Abrahão R","Li QW","Malogolowkin MH","Alvarez EM","Ribeiro RC","Wun T","Keegan THM
  • 发表时间:2020-02-20
Abstract

:Little is known about the incidence of late effects following non-Hodgkin lymphoma (NHL) among adolescent and young adult (AYA, 15-39 years) survivors. Using data from the California Cancer Registry linked to hospital discharge, we estimated the cumulative incidence of late effects at 10 years among AYAs diagnosed with NHL during 1996-2012, who survived ≥2 years. Cox proportional-hazards models were used to investigate the influence of sociodemographic and clinical factors on the occurrence of late effects. Of 4392 HIV-uninfected patients, the highest incident diseases were: endocrine (18·5%), cardiovascular (11·7%), and respiratory (5·0%), followed by secondary primary malignancy (SPM, 2·6%), renal and neurologic (2·2%), liver/pancreatic (2·0%), and avascular necrosis (1·2%). Among the 425 HIV-infected survivors, incidence was higher for all late effects, especially over threefold increased risk of SPM, compared to HIV-uninfected patients (8·1% vs. 2·6%). In multivariable models for HIV-uninfected patients, public or no health insurance (vs. private), residence in lower socioeconomic neighbourhoods (vs. higher), and receipt of a haematopoietic stem cell transplant were associated with a greater risk of most late effects. Our findings of substantial incidence of late effects among NHL AYA survivors emphasise the need for longterm follow-up and appropriate survivorship care to reduce morbidity and mortality in this vulnerable population.

摘要

: 对青少年和年轻成人 (AYA,15-39 岁) 幸存者中非霍奇金淋巴瘤 (NHL) 后晚期效应的发生率知之甚少。使用与出院相关的加州癌症登记处的数据,我们估计了 1996-2012 年期间确诊为 NHL 的 AYAs 中 10 年晚期效应的累积发生率,这些患者存活 ≥ 2 年。采用 Cox 比例风险模型研究社会人口学和临床因素对晚期效应发生的影响。在 4392 例 HIV 未感染患者中,发病率最高的疾病是: 内分泌 (18 · 5%) 、心血管 (11 · 7%) 和呼吸 (5 · 0%),其次是继发性原发性恶性肿瘤 (SPM, 2 · 6% ), 肾脏和神经系统 (2 · 2% ), 肝/胰腺 (2 · 0% ), 缺血性坏死 (1 · 2%))。在 425 例 HIV 感染幸存者中,所有晚期效应的发生率较高,尤其是与 HIV 未感染患者相比,SPM 风险增加了三倍以上 (8 · 1% vs.2 · 6%)。在 HIV 未感染患者的多变量模型中,公共或无健康保险 (vs. 私人),居住在较低的社会经济社区 (vs. 更高),接受造血干细胞移植与大多数晚期效应的风险更大相关。我们对 NHL AYA 幸存者晚期效应大量发生率的研究结果强调,需要长期随访和适当的生存护理,以降低这一弱势人群的发病率和死亡率。

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