Late effects in mantle cell lymphoma patients treated with or without autologous stem cell transplantation.

Studies on late effects in mantle cell lymphoma (MCL) patients are increasingly important as survival is improving and novel targeted drugs are being introduced, however knowledge about late effects is limited. The aim of this population-based study was to describe the magnitude and panorama of late effects among patients treated with or without high-dose chemotherapy with autologous stem cell transplantation (HD-ASCT). The study cohort included all MCL patients, recorded in the Swedish Lymphoma Register, 18-69 years old, diagnosed 2000-2014 (total n=620, treated with HD-ASCT n=247) and 1:10 matched healthy comparators. Patients and comparators were followed via the national Patient Register and Cause-of-Death-Register, from 12 months after diagnosis/matching until December 2017. Incidence rate ratios of numbers of outpatient visits, hospitalizations and bed days were estimated using negative binomial regression models. In relation to the matched comparators, the rate of specialist and hospital visits was significantly higher among MCL patients (IRR 2.0, 95% CI: 1.8-2.2 and 7.2, 95% CI: 6.3-8.3, respectively). MCL patients had especially high relative risks of infectious, respiratory and blood disorders. Within this observation period, no difference in rate of these complications, including secondary neoplasms, was observed between HD-ASCT and non-HD-ASCT treated patients. The majority of patients died from their lymphoma and not from another cause or treatment complication. Taken together, our results imply that the vast majority of the post-treatment healthcare needs are related to the lymphoma disease itself, thus, indicating the need for more efficient treatment options.