1 173例淋巴瘤患者死亡原因调查

韩森; 刘卫平; 季新强; 方健; 刘江美; 殷鹏; 王黎君; 周脉耕; 朱军

doi:10.3969/j.issn.1000-8179.2019.09.287

1 173例淋巴瘤患者死亡原因调查

doi: 10.3969/j.issn.1000-8179.2019.09.287

韩森^①,,
刘卫平^①,
季新强^①,
方健^①,
刘江美^②,
殷鹏^②,
王黎君^②,
周脉耕^②,
朱军^①, ,

①.
北京大学肿瘤医院暨北京市肿瘤防治研究所，恶性肿瘤发病机制及转化研究教育部重点实验室（北京市100142）
②.
中国疾病预防控制中心慢性非传染性疾病预防控制中心

基金项目:

首都卫生发展科研专项项目 2018-1-2151

详细信息

作者简介:
韩森专业方向为肿瘤内科的临床研究。E-mail：handsomehansen1@126.com

通讯作者:
朱军 zhu-jun2017@outlook.com

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- 被引次数: 0
出版历程
- 收稿日期: 2019-03-15
- 修回日期: 2019-04-22
- 刊出日期: 2019-05-15

Causes of death in 1,173 patients with lymphoma

Han Sen^{①
,},
Liu Weiping^①,
Ji Xinqiang^①,
Fang Jian^①,
Liu Jiangmei^②,
Yin Peng^②,
Wang Lijun^②,
Zhou Maigeng^②,
Zhu Jun^{①
, ,}

①.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142, China
②.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100142, China

Funds:

Capital's Funds for Health Improvement and Research 2018-1-2151

摘要

摘要: 目的分析淋巴瘤患者人群的死亡原因和长期预后情况。方法收集北京大学肿瘤医院1995年1月至2017年12月收治的6 200例淋巴瘤患者的基线资料，筛选其中已经发生死亡且死亡原因已知的患者，并收集其临床资料和死亡信息。结果共筛选出1 173例患者，其中男性742例（63.3%），女性431例（36.7%）。中位年龄为56（8~92）岁。霍奇金淋巴瘤（Hodgkin's lymphoma，HL）77例（6.6%），非霍奇金淋巴瘤（non-Hodgkin's lymphoma，NHL）1 095例（93.4%），病理分类不明确1例。总体人群生存期为0~253个月，中位生存期为20个月。直接死亡原因包括淋巴瘤688例（58.7%），各类感染性疾病119例（10.1%），心血管疾病（cardiovascular disease，CVD）96例（8.2%），第二原发肿瘤68例（5.8%），其他疾病202例（17.2%）。根本死亡原因包括淋巴瘤936例（79.8%），第二原发肿瘤94例（8.0%），CVD 75例（6.4%），呼吸系统疾病32例（2.7%）和其他疾病36例（3.1%）。生存期超过5年的217例患者根本死亡原因为淋巴瘤129例（59.4%），第二原发肿瘤38例（17.5%），CVD 35例（16.1%）和其他疾病15例（6.9%）。生存期超过10年的60例患者根本死亡原因为淋巴瘤28例（46.7%），第二原发肿瘤17例（28.3%），CVD 7例（11.7%）和其他疾病8例（13.3%）。结论原发肿瘤仍是淋巴瘤患者死亡的主要原因。第二原发肿瘤和CVD是除原发肿瘤以外最常见的死亡原因，并且随着生存期的延长，二者所致的死亡风险明显增加。
- 淋巴瘤 /
- 死亡原因 /
- 第二原发肿瘤 /
- 心血管病 /
- 肿瘤心脏病学
Abstract: 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.
- lymphoma /
- cause of death /
- second primary tumor /
- cardiovascular disease /
- onco-cardiology

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图 1 1 173例淋巴瘤患者的累积死亡率

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表 1 1 173例淋巴瘤患者的生存情况

表 2 1 173例淋巴瘤患者的直接死亡原因顺位

表 3 1 173例淋巴瘤患者的根本死亡原因顺位

参考文献(18)

[1]	郑荣寿, 孙可欣, 张思维, 等.2015年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志, 2019, 41(1):19-28. doi: 10.3760/cma.j.issn.0253-3766.2019.01.005
[2]	Liu W, Liu J, Song Y, et al. Mortality of lymphoma and myeloma in China, 2004-2017: an observational study[J]. J Hematol Oncol, 2019, 12(1):22. doi: 10.1186/s13045-019-0706-9
[3]	Favier O, Heutte N, Stamatoullas- Bastard A, et al. Survival after Hodgkin lymphoma: causes of death and excess mortality in patients treated in 8 consecutive trials[J]. Cancer, 2009, 115(8):1680- 1691. doi: 10.1002/cncr.v115:8
[4]	Howlader N, Mariotto AB, Besson C, et al. Cancer-specific mortality, cure fraction, and noncancer causes of death among diffuse large B- cell lymphoma patients in the immunochemotherapy era [J]. Cancer, 2017, 123(17):3222-3225. doi: 10.1002/cncr.v123.17
[5]	Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al. 2016 ESC position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC committee for practice guidelines: The task force for cancer treatments and cardiovascular toxicity of the european society of cardiology (ESC)[J]. Eur Heart J, 2016, 37(36):2768-2801. doi: 10.1093/eurheartj/ehw211
[6]	韩森, 李伟, 方健, 等.影响恶性肿瘤诊治的非肿瘤性疾病分析[J].中国肿瘤临床, 2018, 45(10):517-520. doi: 10.3969/j.issn.1000-8179.2018.10.161
[7]	Dignam JJ, Huang L, Ries L, et al. Estimating breast cancer-specific and other cause mortality in clinical trial and population-based cancer registry cohorts[J]. Cancer, 2009, 115(22):5272-5283. doi: 10.1002/cncr.24617
[8]	Du XL, Fox EE, Lai D. Competing causes of death for women with breast cancer and change over time from 1975 to 2003[J]. Am J Clin Oncol, 2008, 31(2):105-116. doi: 10.1097/COC.0b013e318142c865
[9]	Chapman JA, Meng D, Shepherd L, et al. Competing causes of death from a randomized trial of extended adjuvant endocrine therapy for breast cancer[J]. J Natl Cancer Inst, 2008, 100(4):252-260. doi: 10.1093/jnci/djn014
[10]	Bradshaw PT, Stevens J, Khankari N, et al. Cardiovascular disease mortality among breast cancer survivors[J]. Epidemiology, 2016, 27 (5):6-13. http://d.old.wanfangdata.com.cn/NSTLQK/NSTL_QKJJ0231847209/
[11]	韩森, 刘卫平, 朱军.淋巴瘤患者长期随访的死亡原因分析[J].中国肿瘤临床, 2019, 46(2):90-93. doi: 10.3969/j.issn.1000-8179.2019.02.005
[12]	Bhatt VR, Loberiza FR, Jing H, et al. Mortality patterns among recipients of autologous hematopoietic stem cell transplantation for lymphoma and myeloma in the past three decades[J]. Clin Lymph, 2015, 15(7):409-415. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=016e4c448480e7c9f56503a43afe68ad
[13]	Kiserud CE, Loge JH, Fossa A, et al. Mortality is persistently increased in Hodgkin's lymphoma survivors[J]. Eur J Cancer, 2010, 46 (9):1632-1639. doi: 10.1016/j.ejca.2010.02.010
[14]	Aleman BM, van den Belt-Dusebout AW, Klokman WJ, et al. Longterm cause-specific mortality of patients treated for Hodgkin's disease[J]. J Clin Oncol, 2003, 21(8):3431-3439. doi: 10.1200/JCO.2003.07.131
[15]	Avilés A, Díaz-Maqueo JC, García EL, et al. Late lethal events in patients with diffuse large B cell lymphoma: a review of 714 patients treated in a single centre[J]. Leuke Lymph, 2001, 42(4):631-637. doi: 10.3109/10428190109099323
[16]	Mounier N, Heutte N, Thieblemont C, et al. Ten-year relative survival and causes of death in elderly patients treated with R-CHOP or CHOP in the GELA LNH- 985 trial[J]. Clin Lymph, 2012, 12(3):151- 154. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=4d523cb8d6ebfa6adc1e1e93826d2de0
[17]	Cutter DJ, Schaapveld M, Darby SC, et al. Risk of valvular heart disease after treatment for Hodgkin lymphoma[J]. J Natl Cancer Inst, 2015, 107(4):djv008. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=7063b8285a3518c7f3d91ce42522f97b
[18]	van Nimwegen FA, Schaapveld M, Janus CPM, et al. Cardiovascular disease after Hodgkin lymphoma treatment: 40- year disease risk [J]. JAMA Intern Med, 2015, 175(6):1007-1017. doi: 10.1001/jamainternmed.2015.1180