Age-related diseases are more prevalent in younger B-cell NHL survivors versus older survivors

According to the American Cancer Society (ACS), non-Hodgkin’s lymphoma (NHL), is one of the most common cancers in the United States and accounts for approximately 4% of all cancers, and approximately 81,560 people in 2021 would be diagnosed with NHL.1 New findings published in the Cancer Epidemiology, Biomarkers and Prevention suggest that age-related diseases such as acute renal failure, pneumonia and nutritional deficiencies in young B-Cell NHL (B-NHL) survivors are higher than older survivors as compared with their respective cohorts in the general population.2 This study may contribute to further research in the management of acute and chronic diseases as they relate to long-term health outcomes of B-NHL survivors.2

The large population-based study included 2,129 B-NHL survivors, stratified into younger (<65 years old) and older (≥65 years old) cohorts, at least ≥5 years since B-NHL diagnosis, compared to 8,969 individuals from the general population.2 The B-NHL survivors were diagnosed between 1997 and 2015 according to the Utah Cancer Registry.2 Each B-NHL survivor was matched with at least 5 cancer-free individuals by sex, birth state and birth year using the Utah Population Database.2 Clinical outcome data was procured from statewide ambulatory surgery and inpatient data was collected from the Utah Department of Health.2 Additionally, medical records obtained from the University of Utah and Intermountain Healthcare also provided inpatient data.2 For statistical analysis, Cox Proportional Hazards models were utilized to assess risk factors for age-related diseases in the B-NHL cohort.2  

In this study, a range of age-related diseases was examined, however, three showed a significant elevated risk in younger versus older B-NHL survivors compared with their respective general population cohorts: Acute renal failure, pneumonia and nutritional deficiencies.2 Results showed an approximate 2.42-fold increase of pneumonia in the younger B-NHL survivors over a 1.44-fold increase among the older B-NHL survivors (pheterogeneity=0.055).2 For acute renal failure, an approximate 2.24-fold increase was seen in the younger B-NHL survivors while the older B-NHL cohort showed a 1.13-fold increase (pheterogeneity=0.017).2 When nutritional deficiencies were evaluated, a 2.08-fold increase was observed in the young B-NHL survivors in contrast to a 1.25-fold increase in the older B-NHL survivors group (pheterogeneity=0.051).2

Clinical factors were analyzed as well.2 Distant cancer stage diagnosis was seen at the rate of 44.7% in younger B-NHL versus 42.5% in older survivors.2 About 11.4% of younger B-NHL survivors were given hematopoietic cell transplantation in contrast to 2.0% of older survivors.2 Younger B-NHL survivors were given chemotherapy 41.5% of the time as compared to 38.7% of older B-NHL survivors.2 These higher risk percentages seen in the younger B-NHL survivors versus their older counterparts could contribute to the higher folds of increase seen in age-related diseases.2 

Their investigation is the first to demonstrate that there is an elevated risk of renal failure in younger B-NHL versus older B-NHL survivors as compared with their general population cohorts ≥5 years post cancer diagnosis.2 This observation may be attributed to the aggressive cancer treatments given to younger B-NHL survivors.2 This along with other studies provide evidence that rigorous cancer treatments may possibly accelerate the aging process in patients.3-5

In summary, this study illustrates that younger B-NHL survivors are likely to display age-related diseases as compared to older B-NHL survivors.2 Thus, early and recurrent screening for these diseases may be beneficial for standardized care in these circumstances.2 For example, nutritional supplementation during the course of treatment may allow for enhanced quality of life.2 Further studies are needed to gain a better understanding as to what clinical health risks contribute to the age-related diseases seen especially in the young population of B-NHL survivors, so that improved clinical outcomes may be achieved.2

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