Treatment and outcome in non-Hodgkin's lymphoma patients with and without prevalent diabetes mellitus in a population-based cancer registry

Objectives: With an increasing prevalence of diabetes mellitus and non-Hodgkin lymphoma (NHL), the number of patients suffering from both diseases is growing. Our aim was to study the differences in treatment and outcome of NHL patients with and without diabetes mellitus. Materials and Methods: Information was collected from the medical records of all patients with both NHL and diabetes (N = 97) and a random sample of NHL patients without diabetes (N = 106), newly diagnosed and recorded in the population-based Eindhoven Cancer Registry (1997-2004). Follow-up was completed until April 2008. Results: Diabetic NHL patients more often needed dose-adjustments (23% vs. 11%), delays between cycles (31% vs. 17%), and a decrease in the number of cycles (40% vs. 23%) as compared to those without diabetes. This resulted in a lower dose-intensity of doxorubicin and vincristine. Treatment-related toxicity was more frequent in diabetics (mainly hyperglycaemia), whereas haematological toxicity, cardiovascular diseases, infections and neurotoxicity did not differ. Although overall survival was dismal for diabetic patients with indolent NHL, this difference disappeared after adjustment for age, cardiovascular disease and performance status. Conclusion: Although in diabetic NHL patients the dose-intensity of chemotherapy was lower and treatment-related toxicity occurred more often, no significant difference in overall survival was observed between NHL patients with and without diabetes mellitus.

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