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Mortality among patients with diffuse large B-cell lymphoma and mental disorders: a population-based study
Inna Y Gong1, Matthew C Cheung1,2,3, Kelvin K W Chan1,2,3,4
1Department of Medicine, University of Toronto, Toronto, ON, Canada.
Journal of the National Cancer Institute
|August 2, 2023
Summary
Patients with diffuse large B-cell lymphoma (DLBCL) and mental disorders face increased mortality. Postdiagnosis mental disorders significantly worsen both short-term and long-term survival in DLBCL patients.
Area of Science:
- Oncology
- Psychiatry
- Epidemiology
Background:
- Mental disorders are observed in diffuse large B-cell lymphoma (DLBCL) patients.
- Limited research exists on the association between mental disorders and mortality in DLBCL.
Purpose of the Study:
- To investigate the relationship between mental disorders and mortality in DLBCL patients.
- To differentiate the impact of preexisting versus postdiagnosis mental disorders on survival.
Main Methods:
- Population-based study using linked administrative health-care databases in Ontario, Canada.
- Included DLBCL patients (≥18 years) treated with rituximab-based therapy (2005-2017).
- Cox proportional hazards models analyzed mortality risks associated with mental disorders.
Main Results:
- A cohort of 10,299 DLBCL patients was analyzed.
- Postdiagnosis mental disorders were linked to increased 1-year mortality (aHR=1.51).
- Both preexisting (aHR=1.12) and postdiagnosis (aHR=1.63) mental disorders were associated with worse all-cause mortality.
Conclusions:
- Mental disorders, especially those developing after diagnosis, are associated with worse short-term and long-term mortality in DLBCL patients.
- Further research is needed to explore mental health service utilization and mediating factors.
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