Publications by authors named "Lasse H Jakobsen"

The development of new first-line treatments for patients with follicular lymphoma (FL) is becoming increasingly challenging due to already excellent survival outcomes. The present study investigated the outcomes of patients with FL who underwent contemporary first-line therapies but would not have been eligible for inclusion in recent trials and explored how commonly used in/exclusion criteria impacted their survival outcomes. This study included adult patients diagnosed with FL in the period 2000-2018 registered in the Danish Lymphoma Registry.

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Up to 50% of diffuse large B-cell lymphoma (DLBCL) patients are ineligible for participation in clinical trials. Ineligible patients have inferior outcomes, but less is known about the impact of commonly used organ-function-based inclusion criteria on drug efficacy estimates. Data on DLBCL patients treated with CHOP+/-rituximab were retrieved from the Danish Lymphoma Registry.

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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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Overall survival (OS) for patients with a hematological cancer may differ between immigrant and Danish-born patients due to disparities in socioeconomic status, health literacy, and language proficiency. This cohort study aimed to investigate survival and hospitalization according to immigrant status while controlling for confounders. Patients with newly diagnosed hematological cancer in 2000-2020 were identified in the Danish nationwide hematological registers and stratified into Danish-born, Western, and non-Western patients.

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Late toxicities can impact survivorship in patients with classical Hodgkin lymphoma (cHL) with pulmonary toxicity after bleomycin-containing chemotherapy being a concern. The incidence of pulmonary diseases was examined in this Danish population-based study. A total of 1474 adult patients with cHL treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) or BEACOPP (bleomycin, vincristine, etoposide, doxorubicin, cyclophosphamide, procarbazine and prednisone) between 2000 and 2018 were included along with 7370 age- and sex-matched comparators from the background population.

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Importance: In recent years, there has been a focus on reducing the socioeconomic gap in survival for hematological malignant neoplasms. Understanding recent developments is important to develop further intervention to improve care.

Objective: To investigate the temporal trend in associations of socioeconomic status (SES) with survival among 3 aggressive hematological malignant neoplasms: multiple myeloma (MM), acute myeloid leukemia (AML), and diffuse large B-cell lymphoma (DLBCL).

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Cardiovascular diseases, especially congestive heart failure (CHF), are known complications of anthracyclines, but the risk for patients undergoing high-dose chemotherapy and autologous stem cell transplant (HDT-ASCT) is not well established. With T-cell therapies emerging as alternatives, studies of long-term complications after HDT-ASCT are warranted. Danish patients treated with HDT-ASCT for aggressive lymphoma between 2001 and 2017 were matched 1:5 on sex, birth year and Charlson comorbidity score to the general population.

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Article Synopsis
  • Outcome data for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL), especially beyond second-line therapy, is limited outside of clinical trials, making real-world context important.
  • A study in Denmark reviewed medical records of 3753 adults with DLBCL, focusing on 189 patients who received third-line treatment or beyond, with a median age of 71 years and various treatment options including supportive care and clinical trials.
  • Overall survival rates were low, with 2-year estimates at 25% for all patients and 49% for those receiving platinum-based salvage therapy, while certain factors like age, CNS involvement, and elevated LDH indicated poorer outcomes.
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Introduction: Treatment of lymphoma can be associated with cognitive challenges, and some patients may fear development of dementia as long-term complication. Studies report a lower risk of dementia after cancer. Some believe this difference to be a protective mechanism of cancer, others believe it to be driven by bias.

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Standard CHOP treatment includes a high cumulative dose of prednisone, and studies have shown increased fracture risk following CHOP. It is unclear whether reductions in bone mineral density (BMD) are caused by glucocorticoids or by the combination with chemotherapy. Our objective was to determine the effect of obinutuzumab (G)/rituximab (R)-bendamustine versus G/R-CHOP on BMD in follicular lymphoma patients.

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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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  • A study analyzed reproductive patterns in survivors of non-Hodgkin lymphoma (NHL) aged 18-40, revealing conflicting results in previous research and the need for subtype-specific findings.
  • Patients with aggressive lymphoma had significantly lower childbirth rates within the first 3 years post-diagnosis compared to matched population comparators, while those with indolent lymphoma didn’t show a significant difference.
  • Over a 10-year period, childbirth rates for aggressive NHL patients remained lower overall, highlighting the need for fertility counseling, especially for those diagnosed with aggressive subtypes.
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Childbirth rates in classical Hodgkin lymphoma (cHL) survivors have historically been reduced compared to the general population. Understanding if contemporary treatment protocols are associated with reduced fertility is crucial as treatment guidelines shift toward more liberal use of intensive chemotherapy. We identified 2834 individuals aged 18-40 years with cHL in Swedish and Danish lymphoma registers, and in the clinical database at Oslo University Hospital diagnosed 1995-2018, who were linked to national medical birth registers.

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Purpose: Many patients diagnosed with lymphoma are of working age. Cancer patients are known to have a higher risk of sick leave and disability pension, but this has only been delineated for certain subtypes of lymphoma. Therefore, this study aimed at investigating the overall risk of disability pension for all lymphoma subtypes and at quantifying return to work for patients with lymphoma in work before diagnosis.

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  • Peripheral T-Cell Lymphomas (PTCLs) are rare, aggressive cancers that show poor outcomes, particularly in limited-stage disease, which is not well-studied.
  • A study analyzed outcomes and prognostic factors for 239 patients with limited-stage nodal PTCL treated with CHOP(-like) therapy, finding a median follow-up of 127 months and a 5-year overall survival of 58%.
  • Factors like age over 60 and presence of B-symptoms were unfavorable for survival, while young patients without B-symptoms showed significantly better outcomes, with no difference in survival between those receiving 3-4 cycles versus 6-8 cycles of treatment.
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Background And Objective: Within medical research, cure models are useful for analyzing time-to-event data in the scenario where a proportion of the analyzed individuals are expected to never experience the event of interest. Cure models are also useful for modelling the relative survival in scenarios where a proportion of the individuals are expected to eventually experience a mortality rate similar to that of the general population. Here we present two R packages, cuRe and rstpm2, that provide researchers with several tools for performing statistical inference using parametric cure models.

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Patients with cancer have been shown to have increased risk of COVID-19 severity. We previously built and validated the COVID-19 Risk in Oncology Evaluation Tool (CORONET) to predict the likely severity of COVID-19 in patients with active cancer who present to hospital. We assessed the differences in presentation and outcomes of patients with cancer and COVID-19, depending on the wave of the pandemic.

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  • * Results show NHL patients had a higher risk of developing DM within the first year post-treatment, with the most significant risk ratio being 2.7, though the absolute risks were mostly clinically insignificant.
  • * For patients with preexisting DM, there was a temporary increase in the need for insulin treatment and a higher risk of cardiovascular diseases in the first year after chemotherapy, but overall, the increased risks were not considered
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Purpose: Patients with cancer are at increased risk of severe COVID-19 disease, but have heterogeneous presentations and outcomes. Decision-making tools for hospital admission, severity prediction, and increased monitoring for early intervention are critical. We sought to identify features of COVID-19 disease in patients with cancer predicting severe disease and build a decision support online tool, COVID-19 Risk in Oncology Evaluation Tool (CORONET).

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Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure.

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Introduction: The diagnosis of a life-threatening disease can lead to depression and anxiety resulting in pharmacological treatment. However, use of psychotropic drugs (antidepressants, anxiolytics, and antipsychotics) in acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) is undetermined.

Methods: Prescription of psychotropic drugs in Danish AML and MDS patients was compared to a cohort matched on age, sex, and country of origin from the Danish background population using national population-based registries.

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For most patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), R-CHOP immunochemotherapy leads to complete remission and 60-70% of patients remain progression-free after 5 years. Given a median age of 65, it is relevant to disentangle how DLBCL and DLBCL therapy influence health care use among the survivors. In this nationwide study, the health care use among Danish DLBCL patients diagnosed in 2007-2015, who achieved complete remission after R-CHOP(-like) therapy, was explored and compared to matched comparators from the Danish general population.

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Lymphoma patients often receive high glucocorticoid doses as part of standard therapy. Observational studies have shown a substantial risk of glucocorticoid-induced osteoporosis (GIO) with associated fractures. The aim of the SIESTA trial was to determine if oral alendronate (ALN) is a safe and effective prophylaxis against GIO in lymphoma.

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