Adjuvant chemotherapy administration and survival outcomes of lymphoma survivors with common solid tumors: a population-based study†

Abstract

Using the Surveillance, Epidemiology, and End Results database (2004–2015), we compared adjuvant chemotherapy use and survival for three common solid tumors in patients with and without history of lymphoma (DLBCL: diffuse large B cell, HL: Hodgkin lymphoma). Among patients with breast (n = 531,243), colon (n = 108,196), and lung (n = 23,179) cancers, we identified 361, 134, and 37 DLBCL survivors, and 349, 73, and 25 HL survivors, respectively. We found no significant difference between lymphoma survivors and controls in the use of adjuvant chemotherapy, except HL survivors with colon cancer, who had a lower rate. Among chemotherapy recipients, OS was significantly worse among HL survivors with all three cancers, and DLBCL survivors with breast cancer (hazard ratio [HR] 1.57–2.28). HL survivors had significantly higher mortality from cardiovascular diseases in breast and lung cancers (sub-HR, 7.96–9.64), which suggests that worse survival in this population might be due to late or cumulative toxicities of cancer-directed treatment.

Keywords:

• Hodgkin lymphoma
• diffuse large B cell lymphoma
• lymphoma survivorship
• secondary malignancy
• survival
• adjuvant chemotherapy

Acknowledgements

This study used the SEER database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the database.

Disclosure statement

The authors declare no relevant conflict of interest.

Author contributions

Study concept and design: M.D., A.J.O.; Data curation: M.D., A.J.O.; Data analyses: M.D., O.A.P., A.J.O.; Data interpretation: M.D., O.A.P, J.L.R., R.N., A.J.O.; Manuscript writing: M.D., A.J.O.; Manuscript review and editing: M.D., O.A.P, J.L.R., R.N., A.J.O.