Younger Non-Hodgkin Lymphoma Survivors at Higher Risk for Age-Related Diseases

By Megan Brooks

November 08, 2021

NEW YORK (Reuters Health) - Younger survivors of B-cell non-Hodgkin's lymphoma (B-NHL) have a higher risk of developing acute renal failure, and possibly pneumonia and nutritional deficiencies, than their older peers, new research suggests.

"Thanks to therapy improvements, NHL survivors are living longer and thriving in many aspects. However, side effects from the current treatment regimens can be debilitating over time, affecting the overall health of NHL survivors as they age," Dr. Krista Ocier of the University of Utah and Huntsman Cancer Institute, in Salt Lake City, said in a statement.

In 2019, there were more than 700,000 NHL survivors in the United States, with a five-year survival rate of 72.7%. NHL is most often diagnosed in people older than age 65 years, but some subtypes are diagnosed at younger ages and younger patients often undergo more-aggressive treatments, Dr. Ocier and her colleagues note in the journal Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

"There have been several studies on how cardiotoxicity is a common late effect for cancer survivors, often as a result of their cancer treatment," Dr. Ocier told Reuters Health by email. The Utah team previously found that younger NHL survivors have higher relative risks of cardiovascular diseases than their younger counterparts.

In the current study, they evaluated the long-term risk of respiratory, renal and other diseases related to aging among younger versus older NHL survivors. They compared 2,129 B-NHL survivors with 8,969 matched cancer-free individuals from the general population.

They found higher relative risks of acute renal failure, pneumonia, and nutritional deficiencies among NHL survivors younger than 65 years versus those older than 65, compared with their respective general population cohorts.

Compared with the general population, the risk of acute renal failure was increased 2.24-fold in younger survivors versus 1.13-fold in older survivors; the risk of pneumonia was increased 2.42-fold in younger survivors versus 1.44-fold in older survivors; and the risk of nutritional deficiencies was increased 2.08-fold in younger survivors and 1.25-fold in older survivors. None of the risk increases were statistically significant for the older patients, while they all were for the younger group.

At P=0.05, only the relative increase of risk of acute renal failure was significantly higher among young versus old patients, while the increases were borderline-significant for pneumonia and nutritional deficiencies.

There were no significant risk differences for chronic kidney disease and osteoporosis between younger and older survivors, although NHL survivors had an overall elevated risk of these diseases compared with the general population, the researchers found.

"A key action point for primary-care physicians is to be aware that earlier onset of age-related diseases is likely to occur among non-Hodgkin's lymphoma survivors over time. Periodic screening for a range of health outcomes as well as consistent follow-up may help non-Hodgkin's lymphoma survivors manage these potential diseases," Dr. Ocier told Reuters Health.

The study was funded by the National Institutes of Health, the Huntsman Cancer Institute, the Utah Cancer Registry, the U.S. Center for Disease Control and Prevention's National Program of Cancer Registries, the University of Utah, and the Huntsman Cancer Foundation. The authors declared no conflicts of interest.

SOURCE: Cancer Epidemiology, Biomarkers and Prevention, online November 3, 2021.