Risk of Type II Diabetes Mellitus Among B-Cell Non-Hodgkin's Lymphoma Survivors

Advancing therapies have increased B-cell Non-Hodgkin's Lymphoma (B-NHL) patient survival. However, data are limited on the risk of type II diabetes mellitus (type II DM) in adult survivors following treatment. This study examines the risk of type II DM among a Utah population of B-NHL survivors, compared to the general population.

A cohort of 3529 adult survivors diagnosed with B-NHL in Utah between 1997 and 2013 in the Utah Cancer Registry and 13,339 individuals from the general population were identified using the Utah Population Database (UPDB). Multivariate Cox Proportional Hazard models were used to estimate adjusted hazard ratios (aHR) for developing type II DM, stratified for time post-diagnosis.

Compared to the cancer-free population, B-NHL survivors had an overall increased risk of developing type II DM (HR: 1.49; 95% CI: 1.32, 1.69), largely within the first year (HR: 4.41; 95% CI: 3.52, 5.52) following diagnosis. Older B-NHL survivors were more likely to develop type II DM at any time compared to survivors < 40 years [40-65 years (HR: 2.66; 95% CI 1.48-4.79); ≥ 65 years (HR: 3.77; 95% CI 2.09-6.78)]. Obese (BMI > 30 kg/m²) survivors had a 4.06-fold increase in the risk of type II DM compared to normal BMI (18-24.9 kg/m²) cancer survivors. Cancer treatment did not increase the risk of type II DM compared to no treatment.

Adult B-NHL cancer survivors were at an overall increased risk of developing type II DM compared to the general population, within the first year and overall, following a cancer diagnosis. This study provides evidence suggesting the importance of obesity prevention and improvement in care management oversight for B-NHL survivorship and DM outcomes.