Peripheral and cutaneous T-cell lymphomas in the United States: A 21-year mortality analysis (1999-2020).

Abstract

e19055 Background: Peripheral and cutaneous T-cell lymphomas (PTCL and CTCL) comprise of a vast variety of rare and heterogeneous subtypes of non-Hodgkin lymphomas, accounting for almost 15-20% of all lymphomas, with poor prognoses and limited treatment options. The study aims to explore 20-year mortality trends which might help in identifying vulnerable populations and addressing inequities ultimately leading to better survival rates. Methods: We conducted an examination of death certificates sourced from the CDC WONDER database (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) from 1999 to 2020. Mortality rate due to peripheral and cutaneous T-cell lymphomas was assessed using the ICD code C84. Age-Adjusted Mortality Rates (AAMRs) per 100,000 persons, Average Annual Percentage Change (AAPC) and Annual Percent Change (APC) were reported. APCs in AAMRs with 95% CI were obtained using joint point regression analysis across different demographic and geographic subgroups. Results: The AAMR for Peripheral and Cutaneous T-cell lymphomas increased from 0.234 (upper CI=95%; 0.216 to 0.253) in 1999 to 0.343 (upper CI=95%; 0.324 to 0.362) in 2020 with an APC of 4.76% from 1999-2006, followed by an increase of 1.09% from 2006-2020 (p<0.000001). Females exhibited higher AAMRs than males (p= 0.04). Large central metropolitan areas had an increased AAPC (2.647) followed by non-metropolitan areas (AAPC=1.504). The 75-84 year age group reported the highest mortality with 5967 deaths (AAPC=3.747) whereas lower death rates were reported by younger age groups. The North-east reported the highest AAMR (0.392; 95% upper CI, 0.344 to 0.44) followed by South (0.313; upper CI=95%, 0.306 to 0.32), West (0.313; upper CI=95%, 0.304 to 0.322) and mid-West (0.312; upper CI=95%, 0.303 to 0.321). The Black or African American reported the highest AAMR and an APC of 1.908%, p= 0.000032. Pennsylvania had the highest APC (2.881%) whereas a decrease in mortality was observed in California after 2010 (APC=-1.410%,p=0.000013). Conclusions: Over the last two decades, there has been an overall increase in the mortality rate due to peripheral and cutaneous T-cell lymphomas in the United States. Increased AAMRs have been reported by females, older age groups, metropolitan areas, Black or African Americans, North-west regions and states like Pennsylvania representing various disparities among the trends. Interestingly, California reported a decreased mortality during the last decade. These variations in the trends necessitate the need for additional exploration and targeted interventions.