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Stage I non-Hodgkin lymphoma: no plateau in disease-specific survival ?

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Abstract

Stage I non-Hodgkin lymphoma (NHL) is rare; prognostic impact of different histologic subtypes and treatment modality is still unclear. We used the Surveillance, Epidemiology and End Results (SEER) database to evaluate survival outcomes among adult patients (age ≥ 18 years, N = 58,230) diagnosed with stage I NHL of various histologic subtypes between 1998 and 2014. Five-year disease-specific survival of patients with stage I diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), marginal zone lymphoma (MZL), small lymphocytic lymphoma (SLL), Burkitt lymphoma (BL), mantle cell lymphoma (MCL), and peripheral T cell lymphoma (PTCL) was 82%, 92%, 95%, 89%, 78%, 77%, and 77%, respectively. The median disease-specific survival was not reached in all histologic subtypes analyzed; however, there does not appear to be a plateau in disease-specific survival of patients with stage I NHL irrespective of subtypes. Although lymphoma was the most common cause of death (40.7%), death from other cancer (17.4%) and cardiovascular disease (13.6%) were also frequent. Chemotherapy appeared favorably associated with OS in patients with DLBCL, BL, and MCL while patients with FL, MZL, SLL, and PTCL who require chemotherapy for initial treatment showed shorter OS. Patients with stage I NHL have favorable disease-specific survival; however, no plateau was seen regardless of histologic subtypes thus suggesting that patients may need attention and follow-up even in aggressive lymphomas after 5 years of remission.

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Authors and Affiliations

  1. Department of Internal Medicine, University of New Mexico, Albuquerque, NM, 87131, USA

    Dai Chihara

  2. Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Yasuhiro Oki, Michelle A. Fanale, Jason R. Westin, Loretta J. Nastoupil, Sattva Neelapu, Luis Fayad & Nathan H. Fowler

  3. Seattle Genetics, Bothell, Washington, USA

    Michelle A. Fanale

  4. Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

    Chan Yoon Cheah

  5. Department of Haematology, Pathwest Laboratory Medicine, Nedlands, WA, Australia

    Chan Yoon Cheah

  6. Medical School, University of Western Australia, Crawley, WA, Australia

    Chan Yoon Cheah

Authors
  1. Dai Chihara
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  2. Yasuhiro Oki
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  3. Michelle A. Fanale
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  4. Jason R. Westin
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  5. Loretta J. Nastoupil
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  6. Sattva Neelapu
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  7. Luis Fayad
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  8. Nathan H. Fowler
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  9. Chan Yoon Cheah
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Correspondence to Dai Chihara.

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Conflict of interest

Dr Fanale reports grants and personal consulting fees through 06/04/18 from Seattle Genetics and salary and stocks from 10/01/18 following the start of her employment with Seattle Genetics. Grants and personal fees from Takeda through 06/04/18, grants and personal fees from Celgene through 06/04/18, grants from ADC Therapeutics through 06/04/18, grants and personal fees from BMS through 06/04/18, grants and personal fees from Merck through 06/04/18, grants from Molecular Templates through 06/04/18, personal fees from Bayer through 06/04/18, personal fees from Spectrum through 06/04/18, grants from MedImmune through 06/04/18, grants from Gilead through 06/04/18, and grants from Genentech through 06/04/18.

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SEER data is publically available de-identified database and thus deemed not needing approval from institutional review board.

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Chihara, D., Oki, Y., Fanale, M.A. et al. Stage I non-Hodgkin lymphoma: no plateau in disease-specific survival ?. Ann Hematol 98, 1169–1176 (2019). https://doi.org/10.1007/s00277-018-3571-7

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  • DOI: https://doi.org/10.1007/s00277-018-3571-7

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