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Risk of diabetes and the impact on preexisting diabetes in patients with lymphoma treated with steroid-containing immunochemotherapy

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  • Joachim Baech
  • Marianne Tang Severinsen
  • Andreas Kiesbye Øvlisen
  • Henrik Frederiksen
  • Peter Vestergaard
  • Christian Torp-Pedersen
  • Judit Meszaros Jørgensen
  • Michael Roost Clausen
  • Christian Bjørn Poulsen
  • Peter Brown
  • Anne Ortved Gang
  • Robert Pedersen
  • Karin Ekström Smedby
  • Sandra Eloranta
  • Lasse Hjort Hjort Jakobsen
  • Tarec C El Galaly
Vis graf over relationer

First-line treatments for lymphomas often include high doses of prednisolone, but the risks of new-onset diabetes mellitus (DM) or worsening of preexisting DM following treatment with cyclic high dose corticosteroids is unknown. This cohort study matched non-Hodgkin lymphoma (NHL) patients treated with steroid-containing immunochemotherapy (ie, R-CHOP[-like] and R-CVP) between 2002 and 2015 to individuals from the Danish population to investigate the risks of new-onset DM. For patients with preexisting DM, the risks of insulin dependency and anthracycline-associated cardiovascular diseases (CVDs) were assessed. In total, 5672 NHL patients and 28 360 matched comparators were included. Time-varying incidence rate ratios (IRRs) showed increased risk of DM in the first year after treatment compared with matched comparators, with the highest IRR being 2.7. The absolute risks were higher among patients in the first 2 years, but the difference was clinically insignificant. NHL patients with preexisting DM had increased risks of insulin prescriptions with 0.5-, 5-, and 10-year cumulative risk differences of insulin treatment of 15.3, 11.8, and 6.0 percentage units as compared with the DM comparators. In a landmark analysis at 1 year, DM patients with lymphoma had decreased risks of insulin dependency compared with comparators. Time-varying IRRs showed a higher CVD risk for NHL patients with DM as compared with comparators in the first year after treatment. NHL patients treated with steroid-containing immunochemotherapy regimens have a clinically insignificant increased risk of DM in the first year following treatment, and patients with preexisting DM have a temporary increased risk of insulin prescriptions and CVD.

OriginalsprogEngelsk
TidsskriftBlood advances
Vol/bind6
Udgave nummer15
Sider (fra-til)4427-4435
Antal sider9
ISSN2473-9529
DOI
StatusUdgivet - 9 aug. 2022

Bibliografisk note

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