Impact Of Lymphoma Research Articles

2386-PUB: Implications of Lymphoma and Diabetes Mellitus on Patient Outcomes and Care

Background: We examined the impact of diabetes mellitus (DM) on survival in patients with lymphoma and the impact of lymphoma on glycemic control. Methods: Patients with newly diagnosed lymphoma with DM (n=91) were identified from the Institutional Cancer Registry and matched to 91 lymphoma patients without DM according to age, gender and year of cancer diagnosis (2005-2016). The file was linked to the electronic medical record to obtain information on DM and lymphoma therapies and laboratory results. Overall survival (OS) and progression-free survival (PFS) were estimated with the Kaplan-Meier method and compared by Cox regression analysis using stratification for matched pairs. Mixed models were used to compare hemoglobin A1c (HbA1c), glucose and lactate dehydrogenase (LDH) during the year following cancer diagnosis. Results: Mean age of the entire cohort at diagnosis was 73 (range 41-95) years, most (96%) were white. B cell lymphoma accounted for 86% of patients and T cell lymphoma 14%. No differences in race/ethnicity, marital status, alcohol or tobacco use were detected between patients with and without DM. Mean BMI was significantly different between DM and non-DM patients (30.2 (6.5) versus 26.9 (5.6); p=0.003). Among those with DM, mean HbA1c during the year following cancer diagnosis was 6.7%. Mean glucose was significantly different between DM and non-DM pts (140.1 (36.1) versus 107.7 (14.5); p<0.001). Of the DM patients, 51/91 did not have good glycemic control. There was no difference in lactate dehydrogenase (LDH) values between groups. Five-year OS was estimated at 67% (95% CI 56-78%) for DM patients versus 64% (95% CI 53-76%) in non-DM pts. Hazard ratio was 0.64 (95% CI: 0.35 - 1.16; p=0.14). Five-year PFS was estimated at 64% for DM patients versus 57% for non-DM patients. Hazard ratio was 0.60 (95% CI: 0.33-1.08; p=0.09). Conclusions: Lymphoma and its treatment did not affect glycemic control. DM did not adversely impact survival in patients with lymphoma. Disclosure N. Karlin: None. P.M. Verona: None. S. Amin: None. M.R. Buras: None. H.E. Kosiorek: None. C. Cook: None.

The impact of lymphoma and treatment on male fertility

Most patients with Hodgkin’s or non-Hodgkin’s lymphomas will be cured by modern chemotherapy and/or radiotherapy. Although some patients, especially those with Hodgkin’s lymphoma, already have semen alterations related to their disease before treatment, sperm damage is mainly caused by anti-cancer treatments. Alkylating and similar drugs and radiation therapy are the most aggressive agents on male gonadal functions. Sperm damage is dependent on drug dose and individual sensitivity, and the recovery is unpredictable. Current approaches to fertility management include the exclusion of gonadotoxic agents whenever possible, in particular among children and preadolescent boys, and systematic sperm banking for all male patients, especially among adolescent patients and even in cases of poor sperm quality. New techniques of in vitro fertilization allow procreation even with poor sperm quality.