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. 2015 Apr;100(4):525-33.
doi: 10.3324/haematol.2014.107300. Epub 2014 Dec 15.

Trends in incidence, treatment and survival of aggressive B-cell lymphoma in the Netherlands 1989-2010

Djamila E Issa  1 , Saskia A M van de Schans  2 , Martine E D Chamuleau  3 , Henrike E Karim-Kos  4 , Marielle Wondergem  3 , Peter C Huijgens  5 , Jan Willem W Coebergh  4 , Sonja Zweegman  3 , Otto Visser  2
Affiliations

Trends in incidence, treatment and survival of aggressive B-cell lymphoma in the Netherlands 1989-2010

Djamila E Issa et al. Haematologica. 2015 Apr.

Abstract

Only a small number of patients with aggressive B-cell lymphoma take part in clinical trials, and elderly patients in particular are under-represented. Therefore, we studied data of the population-based nationwide Netherlands Cancer Registry to determine trends in incidence, treatment and survival in an unselected patient population. We included all patients aged 15 years and older with newly diagnosed diffuse large B-cell lymphoma or Burkitt lymphoma in the period 1989-2010 and mantle cell lymphoma in the period 2001-2010, with follow up until February 2013. We examined incidence, first-line treatment and survival. We calculated annual percentage of change in incidence and carried out relative survival analyses. Incidence remained stable for diffuse large B-cell lymphoma (n=23,527), while for mantle cell lymphoma (n=1,634) and Burkitt lymphoma (n=724) incidence increased for men and remained stable for women. No increase in survival for patients with aggressive B-cell lymphoma was observed during the period 1989-1993 and the period 1994-1998 [5-year relative survival 42% (95%CI: 39%-45%) and 41% (38%-44%), respectively], but increased to 46% (43%-48%) in the period 1999-2004 and to 58% (56%-61%) in the period 2005-2010. The increase in survival was most prominent in patients under 65 years of age, while there was a smaller increase in patients over 75 years of age. However, when untreated patients were excluded, patients over 75 years of age had a similar increase in survival to younger patients. In the Netherlands, survival for patients with aggressive B-cell lymphoma increased over time, particularly in younger patients, but also in elderly patients when treatment had been initiated. The improvement in survival coincided with the introduction of rituximab therapy and stem cell transplantation into clinical practice.

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Figures

Figure 1.
Figure 1.
(A). Age-standardized incidence rate (ASR) of diffuse large B-cell lymphoma (DLBCL), according to subgroup and sex, in the Netherlands, 1989–2010. (B). Age-standardized incidence rate (ASR) of mantle cell lymphoma (MCL), according to subgroup and sex, in the Netherlands, 2001–2010. (C). Age-standardized incidence rate (ASR) of BL, according to subgroup and sex, in the Netherlands, 1989–2010.
Figure 2.
Figure 2.
(A). Age-standardized incidence rate (ASR) of diffuse large B-cell lymphoma (DLBCL), by sex and age, in the Netherlands, 1989–2010. (B). Age-standardized incidence rate (ASR) of mantle cell lymphoma (MCL), by sex and age, in the Netherlands, 2001–2010.
Figure 3.
Figure 3.
(A). Trends in primary treatment for diffuse large B-cell lymphoma (DLBCL), according to period, stage and age, in the Netherlands, 1989–2010. (B). Trends in primary treatment for mantle cell lymphoma (MCL), according to period, stage and age, in the Netherlands, 2001–2010. (C). Trends in primary treatment for Burkitt lymphoma (BL), according to period and age, in the Netherlands, 1989–2010.
Figure 4.
Figure 4.
(A). Trends in 5-year relative survival for diffuse large B-cell lymphoma (DLBCL) according to age and period, in the Netherlands, 1989–2010. (B). Trends in 5-year relative survival for MCL according to age and period, in the Netherlands, 2001–2010. (C). Trends in 5-year relative survival for diffuse large B-cell lymphoma (DLBCL) according to age and period, in the Netherlands, 1989–2010.
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