Table 2.
Observed (O) and expected (E) numbers of deaths, and overall and cause-specific standardized mortality ratios (SMR) and excess absolute risks (EAR) among 1082 five-year survivors of pediatric non-Hodgkin lymphoma (NHL): Childhood Cancer Survivor Study, North America
| Cause of death (ICD-9) | Years after NHL diagnosis |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5-9 |
10-19 |
At least 20 |
Total at least 5 years from diagnosis |
||||||||||
| O | SMR (95% CI) | EAR | O | SMR (95% CI) | EAR | O | SMR (95% CI) | EAR | O | E | SMR (95% CI) | EAR | |
| All causes | 32 | 7.1 (4.9, 10.0) | 52.1 | 32 | 2.9 (2.0, 4.1) | 21.9 | 23 | 4.2 (2.7, 6.4) | 52.7 | 87 | 20.9 | 4.2 (3.3, 5.1) | 36.3 |
| All cancers | 24 | 87.2 (55.9, 130) | 45.0 | 15 | 18.6 (10.4, 30.7) | 14.8 | 9 | 12.5 (5.7, 23.8) | 24.8 | 48 | 1.8 | 26.7 (19.7, 35.4) | 25.4 |
| Lymphopoietic and hematopoietic | |||||||||||||
| Non-Hodgkin lymphoma* | 23 | 188.1 (119, 282) | 43.4 | 5 | 19.2 (6.2, 44.8) | 4.9 | 3 | 23.7 (4.8, 69.1) | 8.6 | 31 | 0.5 | 60.8 (41.3, 86.4) | 16.7 |
| Leukemias† | 14 | 520.6 (284, 874) | 26.5 | 4 | 49.3 (13.3, 126) | 4.1 | 3 | 57.4 (11.5, 168) | 8.8 | 21 | 0.2 | 131.1 (81.1, 200) | 11.4 |
| All solid tumors‡ | 9 | 113.5 (51.8, 216) | 16.9 | 1 | — | 0 | — | 10 | 0.3 | 37.2 (17.8, 68.4) | 5.3 | ||
| 1 | — | 18.5 (8.8, 34.0) | 9.8 | 6 | 10.2 (3.7, 22.3) | 16.2 | 17 | 1.3 | 13.3 (7.7, 21.3) | 8.6 | |||
| Circulatory system diseases | 2 | 12.1 (1.4, 43.8) | 3.5 | 3 | 4.4 (0.9, 12.8) | 2.4 | 7 | 8.8 (3.5, 18.0) | 18.6 | 12 | 1.7 | 7.3 (3.8, 12.7) | 5.7 |
| Cerebrovascular disease | 1 | — | 0 | — | 1 | — | 2 | 0.2 | 8.3 (0.9, 30.0) | 1.0 | |||
| Cardiac disease | 1 | — | 3 | 5.6 (1.1, 16.4) | 2.6 | 5 | 7.6 (2.5, 17.8) | 13.0 | 9 | 1.3 | 6.9 (3.1, 13.0) | 4.2 | |
| Cardiomyopathy | 1 | — | 2 | 20.2 (2.3, 73.0) | 2.0 | 2 | 25.9 (2.9, 93.6) | 5.8 | 5 | 0.2 | 24.8 (8.0, 57.8) | 2.6 | |
| Other causes of death§ | |||||||||||||
| Pneumonia | 1 | — | 2 | 20.7 (2.3, 74.8) | 2.0 | 0 | — | 3 | 0.2 | 15.4 (3.1, 45.1) | 1.5 | ||
| Digestive system diseases | 0 | — | 0 | — | 2 | 7.9 (0.9, 28.4) | 5.2 | 2 | 0.5 | 4.1 (0.5, 14.9) | 0.8 | ||
| External causes of death | 2 | 0.6 (0.1, 2.1) | −2.7 | 5 | 0.7 (0.2, 1.6) | −2.2 | 3 | 1.3 (0.3, 3.8) | 2.2 | 10 | 12.9 | 0.8 (0.4, 1.4) | −1.6 |
| Suicide | 1 | — | 4 | 2.5 (0.7, 6.3) | 2.5 | 0 | — | 5 | 2.9 | 1.8 (0.6, 4.1) | 1.2 | ||
Death ratios are based on 87 deaths among 1080 subjects who completed the baseline questionnaire, excluding 2 with unknown date of death.
O indicates observed number of deaths; SMR, standardized mortality ratio; CI, confidence interval; EAR, excess absolute risk (expressed per 10,000 person-years); E, expected number of deaths; —, SMRs and CIs are presented where there are 2 or more deaths from a particular cause.
Non-Hodgkin lymphoma includes 5 cases with reticulosarcoma or lymphosarcoma (ICD-9 2000–2009) and 16 cases with other lymphomas
Leukemias include 6 acute lymphoblastic leukemias (ICD-9=2040), 2 acute myeloid leukemias (ICD-9=2050), and 2 unspecified leukemias.
Sites of fatal solid nonhematologic tumors and numbers observed (in parentheses) include oral cavity and pharynx (2), lung (2), bone (2), connective tissue (2), breast (2), brain (2), colon (1), testis (1), kidney (1), and unspecified (2).
Additional causes of death were systemic sclerosis (1), polymyositis (1), septicemia (1), nonmalignant brain neoplasm (1), alcohol-related (1), other metabolic (1), and other/ill-defined (1).