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Summary: Cardiovascular diseases, especially congestive heart failure (CHF), are known complications of anthracyclines, but the risk for patients undergoing high‐dose chemotherapy and autologous stem cell transplant (HDT‐ASCT) is not well established. With T‐cell therapies emerging as alternatives, studies of long‐term complications after HDT‐ASCT are warranted. Danish patients treated with HDT‐ASCT for aggressive lymphoma between 2001 and 2017 were matched 1:5 on sex, birth year and Charlson comorbidity score to the general population. Events were captured using nationwide registers. A total of 787 patients treated with HDT‐ASCT were identified. Median follow‐up was 7.6 years. The risk of CHF was significantly increased in the HDT‐ASCT population compared to matched comparators with an adjusted hazard ratio (HR) of 5.5 (3.8–8.1). The 10‐year cumulative incidence of CHF was 8.0% versus 2.0% (p < 0.001). Male sex, ≥2 lines of therapy, hypertension and cumulative anthracycline dose (≥300 mg/m2) were risk factors for CHF. In a separate cohort of 4089 lymphoma patients, HDT‐ASCT was also significantly associated with increased risk of CHF (adjusted HR of 2.6 [1.8–3.8]) when analysed as a time‐dependent exposure. HDT‐ASCT also increased the risk of other cardiac diseases. These findings are applicable for the benefit/risk assessment of HDT‐ASCT versus novel therapies. [ABSTRACT FROM AUTHOR]

Summary: There is a lack of data regarding treatment and prognosis for the growing group of oldest old patients with lymphoma. Therefore, we studied 2347 patients aged ≥85 years from the Danish and Swedish lymphoma registers 2000–2016 (Denmark) and 2007–2013 (Sweden). Outcome was assessed using relative survival (RS). The 2‐year RS overall for patients with aggressive lymphomas was 38% [95% confidence interval (CI) 35–42%], of whom 845 (66%) patients received active treatment (chemotherapy, radiotherapy, immunotherapy, other). For aggressive lymphomas, not receiving active treatment was associated with an inferior 2‐year RS of 12% (95% CI 9–17%) compared to 49% (95% CI 45–53%) for patients who received active treatment (excess mortality rate ratio 2·84, 95% CI 2·3–3·5; P < 0·0001). For patients with indolent lymphoma, the 2‐year RS was 77% (95% CI 72–82%). Here, 383 (46%) patients received active treatment at diagnosis, but did not have better 2‐year RS (75%, 95% CI 67–81%) compared to those who did not receive active treatment (83%, 95% CI 74–89%). We conclude that outcomes for the oldest old patients with lymphoma are encouraging for several subtypes and that active treatment is associated with improved outcome amongst the oldest old patients with aggressive lymphomas, indicating that age itself should not be a contraindication to treatment. [ABSTRACT FROM AUTHOR]

Summary: The prognosis for mantle cell lymphoma (MCL) remains poor. Our aim was to assess the impact of comorbidities on survival and causes of death. For 1,385 MCL patients (1,009 males, 376 females) diagnosed in 2000–2014 (median age 71 years, range 22–96) comorbidities ≤ 10 years of diagnosis were classified according to the Charlson comorbidity index (CCI; 0, 1, 2+). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to compare lymphoma‐specific and all‐cause mortality rates. Model‐based predictions were used to obtain probabilities of death. Overall, 44% had any comorbidity (CCI 1+) and 28% severe comorbidity (CCI 2+). Over a median follow‐up of 3·7 years (range 0–16), 633 (46%) died, the majority (76%) from lymphoma. Severe comorbidity was independently associated with higher all‐cause [hazard ratio (HR) = 1·52; 95% CI: 1·24–1·85) and lymphoma‐specific mortality (HR = 1·31; 95% CI: 1·04–1·65). Particularly among patients with connective tissue, renal and psychiatric diseases, and dementia. Among females with any comorbidity, non‐lymphoma deaths represented a larger proportion of all deaths, compared to males with any comorbidity. In general, more efficient lymphoma treatments need to be considered also for patients with severe comorbidity. However, among females with any comorbidity, the likelihood of non‐lymphoma death was still considerable, perhaps favouring a more liberal use of a "wait and watch" approach. [ABSTRACT FROM AUTHOR]