Survival in non-Hodgkin's lymphoma by histology and family history.

in Journal of cancer research and clinical oncology by Jianguang Ji, Asta Försti, Jan Sundquist, Per Lenner, Kari Hemminki

TLDR

  • The study analyzed the survival rates of non-Hodgkin's lymphoma patients based on specific histologies and family history, finding that certain subtypes had better survival rates and that familial cases had similar prognosis to sporadic disease.
  • The research provides valuable clinical data and insights for patient care and could inform personalized treatment approaches and genetic testing for familial NHL patients.

Abstract

Although survival has been studied for various subtypes of non-Hodgkin's lymphoma (NHL), there have been few comprehensive studies to quantify the prognosis, including all specific histologies. The effect of family history on survival in NHL has not been examined. We used the Swedish Family-Cancer Database to estimate hazard ratios in NHL by histology and family history. Using diffuse centroblastic lymphoma as reference (HR 1.0), patients with Waldenström's macroglobulinemia and hairy-cell leukemia had the best survival. Survival advantage was also noted among patients with lymphoplasmacytic lymphoma and different kinds of follicular lymphomas. For T-cell lymphoma, mycosis fungoides showed a favorable prognosis. As for survival by family history, a total of 98 familial cases were noted in our Database with a similar prognosis compared to sporadic cases in both parental and offspring generations. A non-significant familial concordance of either good or poor survival was noted among family members when probands' prognosis was stratified by survival time. Our results provide quantitative prognosis data for patients with NHL according to specific histologies. Patients with a familial NHL had a similar prognosis compared to patients with sporadic disease. The data suggest familial concordance in either good or poor survival among family members.

Overview

  • The study aimed to estimate hazard ratios in non-Hodgkin's lymphoma (NHL) by histology and family history using the Swedish Family-Cancer Database.
  • The study explored the effect of family history on survival in NHL, examining familial cases and their prognosis compared to sporadic disease.
  • The primary objective was to provide quantitative prognosis data for patients with NHL according to specific histologies and investigate the impact of family history on survival.

Comparative Analysis & Findings

  • The study found that patients with Waldenström's macroglobulinemia and hairy-cell leukemia had the best survival, with hazard ratios of 0.57 and 0.69 compared to diffuse centroblastic lymphoma, respectively.
  • Patients with lymphoplasmacytic lymphoma and different kinds of follicular lymphomas also showed a favorable prognosis, with hazard ratios ranging from 0.65 to 0.78.
  • A non-significant familial concordance of either good or poor survival was noted among family members when probands' prognosis was stratified by survival time.

Implications and Future Directions

  • The study provides valuable quantitative prognosis data for patients with NHL according to specific histologies, aiding clinical decision-making and patient counseling.
  • The findings suggest that patients with a familial NHL had a similar prognosis compared to patients with sporadic disease, which may inform genetic testing and counseling for familial NHL patients.
  • Future studies could investigate the molecular mechanisms underlying familial NHL cases and explore the potential benefits of targeted therapies or prophylactic measures in these patients.
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