Objective  To understand the causes of death and long-term prognosis of lymphoma patients.

  Methods  Data from 6 200 patients with lymphoma admitted to the Department of Lymphoma, Peking University Cancer Hospital, from January 1995 to December 2017, were collected. Those who had died and whose causes of death were known were selected. Clinical records and information on death were collected.

  Results  A total of 1,173 patients were selected, 742 of whom were male (63.3%), and 431 were female (36.7%). The median age was 56 (8-92) years. There were 77 cases (6.6%) of Hodgkin's lymphoma, 1,095 cases (93.4%) of non-Hodgkin's lymphoma, and 1 case of unclear pathological classification. Overall population survival was 0-253 months, with a median survival rate of 20 months. The direct causes of death included lymphoma in 688 (58.7%), various infectious diseases in 119 (10.1%), cardiovascular diseases in 96 (8.2%), secondary primary tumors in 68 (5.8%), and other diseases in 202 cases (17.2%). The underlying causes of death included lymphoma in 936 (79.8%), secondary primary tumors in 94 (8.0%), cardiovascular diseases in 75 (6.4%), respiratory diseases in 32 (2.7%) and other diseases in 36 cases (3.1%). The underlying causes of death in cases wherein survival time exceeded 5 years included lymphoma in 129 (59.4%), secondary primary tumors in 38 (17.5%), cardiovascular diseases in 35 (16.1%), and other diseases in 15 cases (6.9%). The underlying causes of death in cases wherein survival time exceeded 10 years included lymphoma in 28 (46.7%), secondary primary tumors in 17 (28.3%), cardiovascular diseases in 7 (11.7%), and other diseases in 8 cases (13.3%).

  Conclusions  Primary tumors remain the main cause of death in patients with lymphoma. After primary tumors, secondary primary tumors and cardiovascular diseases are the most common causes of death, and with the prolongation of survival, the risk of death caused by these factors increases significantly.