Patients with lymphoplasmacytic lymphoma (LPL) or Waldenström macroglobulinemia (WM) appear to have elevated non-cancer mortality risks, especially within 1 year of diagnosis, according to a study published in the British Journal of Haematology.

The study, which is believed to be the largest population-based mortality study of LPL/WM to date, used data from the Surveillance, Epidemiology and End Results (SEER) registry to assess cause-specific and excess mortality for adult patients with LPL or WM between 2000 and 2016 compared with the general US population.

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The team identified the causes of death for 7289 adults who had been diagnosed with incident first primary LPL (3108 patients) or WM (4181 patients). For patients younger than 65 years at diagnosis (3132 patients), the 16-year cumulative mortality was 23.2% for lymphomas, 8.4% for nonlymphoma cancers, and 14.7% for noncancer causes; for patients 75 years of age or older, the rates were 33.4%, 11.2%, and 48.7%, respectively.

Patients with LPL/WM had a 20% higher risk for death due to noncancer causes compared with the general population (standardized mortality ratio [SMR], 1.2; 95% CI, 1.1-1.2). The most common noncancer causes were infectious (188 patients; SMR, 1.8; 95% CI, 1.6-2.1), respiratory (143 patients; SMR, 1.2; 95% CI, 1.0-1.4), and digestive (80 patients; SMR, 1.8; 95% CI, 1.4-2.2) diseases. These risks were highest within the first year after diagnosis (SMR at < 1 year, 1.3; 95% CI, 1.2-1.5).

Patients with LPL/WM also had a 30% higher risk for death due to nonlymphoma cancers compared with the general population (SMR 1.3; 95% CI, 1.2-1.4), including death due to myelodysplastic syndrome/acute myeloid leukemia (46 patients; SMR, 4.4; 95% CI, 3.2-5.9); among survivors of at least 5 years, risk for death because of solid neoplasm was also higher (145 patients; SMR at ≥ 5 years, 1.3; 95% CI, 1.1-1.5).

“These findings provide a framework for optimising follow-up care strategies based on patient age and time since diagnosis,” wrote the researchers. “In particular, noncancer conditions result in excess mortality, especially within the first year after diagnosis, and should be an area of increased clinical focus.”

Reference

1.     Dalal NH, Dores GM, Curtis RE, Linet MS, Morton LM. Cause‐specific mortality in individuals with lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia, 2000–2016 [published online February 23, 2020]. Br J Haematol. doi:10.1111/bjh.16492