A German perspective on the impact of socioeconomic status in diffuse large B-cell lymphoma

IF 12.9 1区医学 Q1 HEMATOLOGY Blood Cancer Journal Pub Date : 2024-10-11 DOI:10.1038/s41408-024-01158-9

Susanne Ghandili, Judith Dierlamm, Carsten Bokemeyer, Henrik Kusche, Frederik Peters

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Abstract

The prognostic influence of socioeconomic status (SES) on the survival of diffuse large B-cell lymphoma (DLBCL) patients remains controversial. This observational study examines the potential impact of regional SES inequalities on overall survival (OS) among DLBCL patients in Germany. We analyzed data from the German nationwide population-based dataset spanning 2004-2019 sourced from the German Center for Cancer Registry Data (n = 49,465). The primary objective was to assess the 5-year OS among patients with low SES compared to those living in middle and high SES areas. SES was grouped according to quintiles of the German Index of Socioeconomic Deprivation, which summarized nine indicators covering aspects of regional education, employment, and income. DLBCL patients in low SES areas had significantly impaired 5-year OS compared to those in middle and high SES regions (59.2% vs. 61.8% vs. 64.1%, p < 0.0001). Yet, additionally accounting for regional premature mortality removed the impact of SES on survival (Hazard Ratio 0.94, 95% CI 0.87–1.01). Our findings indicate that the prognostic impact of socioeconomic deprivation on long-term survival is not due to variations in diagnosis and treatment of DLBCL itself but rather a higher comorbidity burden.

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从德国视角看社会经济状况对弥漫大 B 细胞淋巴瘤的影响

社会经济地位（SES）对弥漫大 B 细胞淋巴瘤（DLBCL）患者生存期的预后影响仍存在争议。本观察性研究探讨了德国地区性社会经济地位不平等对弥漫性大 B 细胞淋巴瘤患者总生存期（OS）的潜在影响。我们分析了德国癌症登记数据中心提供的 2004-2019 年德国全国人口数据集的数据（n = 49,465）。主要目的是评估与生活在中高社会经济地位地区的患者相比，低社会经济地位患者的5年OS。SES根据德国社会经济贫困指数的五分位数进行分组，该指数汇总了涵盖地区教育、就业和收入等方面的九项指标。与中高社会经济地位地区的患者相比，低社会经济地位地区的DLBCL患者的5年OS明显降低（59.2% vs. 61.8% vs. 64.1%，p <0.0001）。然而，如果再考虑地区过早死亡率，SES 对生存的影响就会消失（危险比 0.94，95% CI 0.87-1.01）。我们的研究结果表明，社会经济贫困对长期生存的预后影响并不是由于DLBCL诊断和治疗本身的差异，而是由于较高的合并症负担。

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来源期刊

Blood Cancer Journal ONCOLOGY-

CiteScore

16.70

自引率

2.30%

发文量

153

审稿时长

>12 weeks

期刊介绍： Blood Cancer Journal is dedicated to publishing high-quality articles related to hematologic malignancies and related disorders. The journal welcomes submissions of original research, reviews, guidelines, and letters that are deemed to have a significant impact in the field. While the journal covers a wide range of topics, it particularly focuses on areas such as: Preclinical studies of new compounds, especially those that provide mechanistic insights Clinical trials and observations Reviews related to new drugs and current management of hematologic malignancies Novel observations related to new mutations, molecular pathways, and tumor genomics Blood Cancer Journal offers a forum for expedited publication of novel observations regarding new mutations or altered pathways.