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NHL Comorbidity Measures: Comparable Prognostic Impact

April, 04, 2024 | Lymphoma

KEY TAKEAWAYS

  • The study aimed to assess the correlation between individual comorbidities, comorbidity indices, and survival in elderly NHL, including specific subtypes.
  • The results indicated that TRES and NHL-5 scores, also CCI and NCI, were used to predict survival.

Max J Gordon and the team conducted a study that aimed to evaluate how individual comorbidities, comorbidity indices, and survival correlate in older adults with non-Hodgkin lymphoma (NHL), including specific subtypes.

The study utilized SEER-Medicare data, including adults aged 65 and older diagnosed with NHL from 2008 to 2017. All incident cases meeting inclusion criteria were included. Comorbidities were categorized using the three-factor risk estimate scale (TRES), Charlson comorbidity index (CCI), and National Cancer Institute (NCI) indices.

Overall survival (OS) and lymphoma-specific survival were assessed using Kaplan-Meier analysis, considering death from other causes as a competing risk. Multivariable Cox models were employed, with Harrel C-statistics comparing comorbidity models. A significance threshold of P< .05 was applied.

The results revealed that among 40,486 newly diagnosed patients with NHL, those with aggressive NHL exhibited higher baseline comorbidity rates. Despite subtype-based variations in baseline comorbidity, cardiovascular, pulmonary, diabetes, and renal conditions were prevalent and consistently linked with OS across most NHL subtypes.

These factors were integrated into the NHL-5 comorbidity score. Comparison of TRES, CCI, NCI, and NHL-5 scores demonstrated comparable associations with OS and lymphoma-specific survival. Sensitivity analyses by NHL subtypes corroborated these findings.

The study concluded that the 3-category TRES and 5-category NHL-5 scores are as effective as the more complex 14-16-category CCI and NCI scores in predicting OS and lymphoma-specific survival. These simplified scoring systems offer clinical utility without sacrificing prognostic accuracy.

No funding-related information was available.

Source: https://pubmed.ncbi.nlm.nih.gov/38684043/

Gordon MJ, Duan Z, Zhao H, et al. (2024) “Comparison of Comorbidity Models Within a Population-Based Cohort of Older Adults With Non-Hodgkin Lymphoma.” JCO Clin Cancer Inform. 2024 Apr;8:e2300223. doi: 10.1200/CCI.23.00223. PMID: 38684043.

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