Statin and cyclooxygenase-2 inhibitors improve survival in newly diagnosed diffuse large B-cell lymphoma: a large population-based study of 4913 subjects.
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
/ administration & dosage
Child
Child, Preschool
Comorbidity
Cyclooxygenase 2 Inhibitors
/ administration & dosage
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ administration & dosage
Lymphoma, Large B-Cell, Diffuse
/ diagnosis
Male
Middle Aged
Mortality
Neoplasm Staging
Population Surveillance
Prognosis
Retrospective Studies
Treatment Outcome
Young Adult
COX-2 inhibitor
DLBCL
metformin
statin
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
05
01
2020
accepted:
10
03
2020
pubmed:
19
4
2020
medline:
23
3
2021
entrez:
19
4
2020
Statut:
ppublish
Résumé
Preclinical data suggests anti-lymphoma potential for statins, metformin and cyclooxygenase-2 (COX-2) inhibitors. We performed a retrospective population-based study of all adults aged ≥66 years diagnosed with diffuse large B-cell lymphoma (DLBCL) or transformed lymphoma treated with a rituximab containing regimen, between 2005 and 2015 in Ontario, Canada. Using administrative databases, we assessed the impact of medication exposures, prior to chemo-immunotherapy, on lymphoma survival. Cox regression analyses, controlling for sociodemographic factors and comorbidities, examined the relationship between medication exposure and survival. In total, 4913 patients were treated with curative intent (median age 75 years, 51% male) and 52·2% died at a median of 1 year from treatment initiation (67% due to DLBCL). In the year prior to commencing treatment, 45·7% received statins, 16·3% metformin, and 25·0% a COX-2 inhibitor. Adjusting for confounders, exposure to statin and COX-2 inhibitors prior to chemo-immunotherapy independently conferred a survival advantage: statin exposure for 30 days (hazard ratio [HR] 0·97, 95% confidence interval [CI] 0·96-0·98), 180 days (HR 0·84, 95% CI 0·80-0·89) and 365 days (HR 0·71, 95% CI 0·63-0·79) and COX-2 inhibitor exposure for 30 days (HR 0·95, 95% CI 0·95-0·98), 180 days (HR 0·76, 95% CI 0·66-0·86) and 365 days (HR 0·57, 95% CI 0·43-0·74). Metformin had no significant impact. This population-based study found a dose-related survival benefit of exposure to statins and COX-2 inhibitors prior to chemo-immunotherapy for newly diagnosed DLBCL.
Substances chimiques
Antineoplastic Agents
0
Cyclooxygenase 2 Inhibitors
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
396-404Subventions
Organisme : ICES
Organisme : Ontario Ministry of Health and Long-Term Care (MOHTLC)
Organisme : Roy and Marjorie Linden Fund
Organisme : Joan Fisher and James Rowland Fund
Informations de copyright
© 2020 British Society for Haematology and John Wiley & Sons Ltd.
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