Publications by authors named "Karin E Smedby"

Introduction: Congestive heart failure (CHF) is a known complication after anthracyclines and radiotherapy for classical Hodgkin lymphoma (cHL). Contemporary cHL treatment may be associated with less risk because radiotherapy use and techniques have changed substantially over time.

Methods: In this study, Swedish cHL patients diagnosed in 2000-2018, and treated with adriamycin [doxorubicin], bleomycin, vinblastine, and dacarbazine (ABVD) or bleomycin, etoposide, Adriamycin [doxorubicin], cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), were matched 1:10 to the general population on birth year and sex to investigate relative rates and cumulative risks of CHF.

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Purpose: To examine health-related quality of life (HRQoL) and supportive care needs among young adult (YA) cancer survivors up to 3 years post-diagnosis.

Methods: A national cohort of individuals diagnosed at 18-39 years with breast, cervical, ovarian, or testicular cancer, lymphoma or brain tumor was approached with surveys at 1.5 (n = 1010, response rate 67%) and 3 (n = 722) years post-diagnosis.

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  • Chronic lymphocytic leukemia (CLL) varies greatly among patients, with some experiencing slow progression and others facing aggressive forms leading to early death.
  • A study with 1,154 CLL patients examined how lifestyle and medical history factors before diagnosis influenced the time until first treatment (TTFT), adjusting for the CLL-International Prognostic Index (CLL-IPI).
  • Results indicated that the CLL-IPI score was the main factor affecting TTFT, with minimal influence from lifestyle factors, providing reassurance to patients about the limited impact of these factors on their disease progression.
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  • Massively parallel sequencing enhances our understanding of genes and their links to diseases, especially in cancer patients, but it complicates the process of clinical decision-making due to the need for extensive manual analysis of genetic variants.
  • Aiming to improve diagnostics for lymphoma, a proposed solution involves systematic variant filtering and interpretation, utilizing machine learning techniques to assist healthcare professionals in diagnosing.
  • The developed blueprint incorporates insights from specialists and identifies essential components like algorithms, software, and bioinformatics, while emphasizing that human evaluators must still verify and validate the classifications made by the AI-driven system.
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  • The study included 98 transplanted and 474 non-transplanted CRC patients, revealing that transplanted individuals were less likely to undergo surgery and receive adjuvant chemotherapy; additionally, transplanted rectal cancer patients saw higher relapse rates.
  • Five-year survival rates were significantly lower for transplanted CRC patients (56% cancer-specific, 35% overall) compared to non-transplanted patients (68% cancer-specific, 57% overall), suggesting the need for more integrated care involving transplantation specialists.
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Validation of biobanks and large cancer cohorts is essential in ensuring high-quality research results. We examined the coverage, generalisability and validity of the lymphoma collection of the Uppsala-Umeå Comprehensive Cancer Consortium (U-CAN) biobank in Sweden, one of the largest cancer biobanks in Europe. Up until 2022, 889 lymphoma patients in U-CAN Uppsala had available samples, and 329 in U-CAN Umeå.

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Purpose: Etoposide to standard R-CHOP is used for high-risk diffuse large B-cell lymphoma (DLBCL) in some countries. Due to the lack of randomized trials, a real-world data study using matching methods was used to test the potential effectiveness of R-CHOEP over R-CHOP.

Patients And Methods: This study included patients from the Danish Lymphoma Register diagnosed between 2006 and 2020 at the age of 18-60 years with de novo DLBCL and age-adjusted IPI ≥2.

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Advancements in treatments have significantly improved the prognosis for mantle cell lymphoma (MCL), and there is a growing population of survivors with an increased susceptibility to infections. We assessed the incidence of infections by clinical characteristics and treatment both before and after MCL diagnosis in Sweden. Patients with a diagnosis of MCL ≥ 18 years between 2007 and 2019 were included, along with up to 10 matched comparators.

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Follicular lymphoma (FL) is a clinically heterogeneous disease. The need for treatment, treatment sequencing, number of treatment lines, and its association with survival have not been described in a population-based setting. We identified all patients diagnosed with FL in the Swedish Lymphoma register from 2007 to 2014, followed until 2020, with detailed data on progression/relapse, transformation, and 2nd and further lines of therapy.

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  • Patients with mantle cell lymphoma (MCL) who relapse are split into two groups: early and late progression, based on how long it's been since their diagnosis.
  • This study looked at treatment outcomes for 385 late-POD patients treated with two kinds of therapies: Bruton tyrosine kinase inhibitors (BTKi) and chemoimmunotherapy (CIT).
  • Findings showed that BTKi treatment led to longer survival without disease progression compared to CIT, suggesting it might be the better choice for these patients.
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Purpose: Patients diagnosed with advanced-stage Hodgkin lymphoma (aHL) have historically been risk-stratified using the International Prognostic Score (IPS). This study investigated if a machine learning (ML) approach could outperform existing models when it comes to predicting overall survival (OS) and progression-free survival (PFS).

Patients And Methods: This study used patient data from the Danish National Lymphoma Register for model development (development cohort).

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Background & Purpose: The COVID-19 pandemic posed a large challenge for healthcare systems across the world. Comprehensive data on the impact of the COVID-19 pandemic on incidence and mortality in lymphoma are lacking.

Patients/methods: Using data from the Swedish lymphoma register, we compare incidence and 1-year survival of lymphoma patients in Sweden before (2017-2019) and during the pandemic (2020 and 2021).

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Background: Increased risk of neoplastic events after recombinant human growth hormone (rhGH) treatment in childhood has been an ongoing concern but long-term safety data are limited.

Methods: A nationwide population-based cohort study in Sweden of patients treated with rhGH during childhood between 1985-2010, due to isolated growth hormone deficiency (GHD), small for gestational age (SGA) and idiopathic short stature (ISS). The comparison group consisted of 15 age-, sex-, and region-matched controls per patient, randomly selected from the general population.

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Purpose: To describe long-term prescribed drug use after rectal cancer treatment.

Methods: We identified 12,871 rectal cancer patients without distant metastasis between 2005 and 2016 and 64,341 matched population comparators using CRCBaSe (a Swedish nationwide register linkage of colorectal cancer patients). Mean defined daily doses (DDDs) of drug dispensing during relapse-free follow-up were calculated by Anatomical Therapeutic Chemical drug categories.

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Background: Cure fraction-the proportion of persons considered cured of cancer after long-term follow-up-reflects the total impact of cancer control strategies, including screening, without lead-time bias. Previous studies have not reported stage-stratified cure fraction across the spectrum of cancer types.

Methods: Using a mixture cure model, we estimated cure fraction across stages for 21 cancer types and additional subtypes.

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Purpose: With modern treatments, mantle cell lymphoma (MCL) patients more frequently experience long-lasting remission resulting in a growing population of long-term survivors. Follow-up care includes identification and management of treatment-related late-effects, such as secondary malignancies (SM). We conducted a population-based study to describe the burden of SM in MCL patients.

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Background: Cancer treatment during reproductive ages may negatively impact fertility and there is a need of firm knowledge about the prevalence and predictors of fertility-related distress. The aim was to examine fertility-related distress in a population-based sample of young women and men recently treated for cancer and to identify predictors for this outcome.

Material And Methods: This nationwide cohort study included 1010 individuals (694 women and 316 men), mean age 34.

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  • The study investigates the effectiveness of high-dose methotrexate (HD-MTX) in preventing CNS (central nervous system) progression in high-risk patients with aggressive B-cell lymphoma.
  • It involved over 2,400 patients, comparing those who received HD-MTX to those who did not, and found a lower risk of CNS progression in the overall group but no significant results in patients who had a complete response after initial treatment.
  • Ultimately, the research concluded that HD-MTX did not show a clear benefit in reducing CNS progression risk, with 7.2% of high-risk patients still progressing over two years.
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Background: Second primary malignancies (SPMs) are known complications after chemotherapy, but the risk is not well characterised for patients with lymphoma treated with high-dose chemotherapy and autologous haematopoietic stem-cell transplantation (HSCT). We aimed to investigate the rate of SPMs in this population relative to matched control individuals from the general population.

Methods: In this retrospective, population-based cohort study, patients aged 18 years or older with an aggressive lymphoma who received high-dose chemotherapy and autologous HSCT in Denmark between Jan 1, 2001, and Dec 31, 2017, were included from the Danish Lymphoma Registry and matched (1:5) to control individuals from the general population on birth year and sex via the Danish Civil Registration System.

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Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL.

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Genetic testing has been applied for decades in clinical routine diagnostics of hematological malignancies to improve disease (sub)classification, prognostication, patient management, and survival. In recent classifications of hematological malignancies, disease subtypes are defined by key recurrent genetic alterations detected by conventional methods (i.e.

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