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 (p_{heterogeneity}=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 (p_{heterogeneity}=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 (p_{heterogeneity}=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