Since the 1990s, the survival rates for patients with non-Hodgkin lymphoma (NHL) appear to have increased, according to a report published in the March 10 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
Non-Hodgkin’s lymphoma is a set of different cancers of the lymphocytes in the immune system, and they can affect any of the organs related to the lymph system. While it is often associated with HIV infection, many of its causes have eluded scientists. It affects approximately 20 out of every 100,000 individuals, and progression outcomes are varied but rarely optimistic. Treatment for this condition has developed enormously in recent years due to the development of novel monoclonal antibody therapies in relation to HIV related lymphomas.
To assess the success of these new therapies in the NHL population, Dianne Pulte, M.D., of the German Cancer Research Center, Heidelberg, and colleagues examined data from the U.S. National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program. Based on two year time intervals between 1990 and 2004, survival rates were calculated: within which patients were diagnosed with NHL, by age group (five groups ranging between 15 and 75 or more years old), sex, race, tumor location (ie: was the cancer cound in a lymph node or a location other than a lymph node) and histological subtype (high grade or low grade tumors).
The authors write with positive results for NHL patients related to five and ten year survival rates. “Overall, five-year relative survival increased from 50.4 percent to 66.8 percent, and 10-year relative survival increased from 39.4 percent to 56.3 percent between 1990 to 1992 and 2002 to 2004.” They continue: “Improvements were most pronounced in patients younger than 45 years (plus 26.8 and plus 27.1 percentage points for five- and 10-year survival, respectively), but improvements were seen in all age groups, in both sexes, in both nodal and extranodal disease and in both low-grade and high-grade disease. Improvements in prognosis were less in black patients than in white patients, especially in younger black patients.”
The authors attribute these improvements to two potential sources: the first is therapeutic advances for NFL itself. “One is advances in therapy that have occurred between 1990 and 2004, particularly the introduction of antibody therapy for non-Hodgkin lymphoma,” they write. “Treatment with antibody therapy and chemotherapy has extended life expectancy in many cases, but whether and how often this extension represents a true cure is still unknown.” The second reason they attribute to advances in HIV treatment — these have reduced the occurrence of HIV-related non-Hodgkin lymphomas and also made them easier to treat.
“Our estimates of long-term survival in patients with non-Hodgkin lymphoma obtained by the period analysis method for the 2002 to 2004 period are much higher than previously available survival estimates, which mostly pertain to patients diagnosed in the 1990s,” the authors say. “Timely disclosure of the improvements in survival achieved in patients, clinicians, researchers and the public is essential.”
Ongoing Improvement in Outcomes for Patients Diagnosed as Having Non-Hodgkin Lymphoma From the 1990s to the Early 21st Century
Dianne Pulte, MD; Adam Gondos, PhD; Hermann Brenner, MD, MPH
Arch Intern Med. 2008;168(5):469-476
Written by Anna Sophia McKenney