Study findings have led experts to suggest that comorbidities in patients with non-Hodgkin’s lymphoma do not present randomly, but have distinct patterns, according to research presented at the National Comprehensive Cancer Network 2021 Virtual Annual Conference.

“Comorbidity in elderly has made it difficult to manage when they are affected by aggressive non-Hodgkin's lymphoma. This has led to the historical achievement of poor outcomes, hence the analysis of the impact of comorbidity in this group of patients is becoming increasingly valid,” wrote Dr. Karen Valdés-Díaz and colleagues.

The analysis aimed to determine the association between patterns of comorbidity and response to first-line treatment, hospitalizations, hospital satay, mortality and overall survival. To determine comorbidity clusters, a 2-step cluster method was used. Those comorbidities that make up the Charlson index were included, and the Akaike Information Criterion was used as a cluster criterion.

Out of a total of 75 patients with a median age of 70, the median hospital stay for clusters 1 and 2 was 10 days (interquartile range between 0 to 11 and 8 to 19, respectively). The median hospitalization in cluster 1 and cluster 2 was 1, while in cluster 3 no hospitalizations were observed (interquartile range between 0 and 2 and 1 and 3, respectively). Most patients in cluster 2 had no response (38.5%) to first-line treatment and 15.4% had disease progression. Mortality was higher in cluster 2 (92.3%), followed by cluster 1 (66.7%) and cluster 3 (29.5%). Cluster 2 presented worse global survival (HR 4.63, 95% CI, 1.89-11.32, p=0.001), identified by Cox’s multivariate proportional risk analysis.

Researchers concluded that comorbidities in patients with lymphoma do not present randomly, but have well-defined patterns. Patients without comorbidities have better outcomes.

Among patients who present comorbidities, conditions that determine worse prognosis are heart disease, diabetes mellitus with target organ damage, and connective tissue disease.—Emily Bader

Valdés-Díaz K, Hernández-Negrín H, Valdés-Leiva L, et el. Impact of Comorbidity Patterns on the Outcomes of Older Patients With Diffuse Large B- Cell Lymphoma. Presented at: the NCCN 2021 Virtual Annual Conference, March 18-20,2021; Virtual. Abstract CLO21-029.