Norwegian Registry of Lymphoid Malignancies
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In 2024, 2404 people were diagnosed with malignant lymphoma, lymphoid leukemia, or myelomatosis in Norway. Improved diagnostics and treatment have led to increased survival for all subgroups of B-cell lymphomas over the past 15 years.
Summary from the annual report 2024
The results chapter is divided into six subchapters; Hodgkin lymphoma, non-Hodgkin lymphoma, mature lymphoid leukaemia, myeloma, lymphoblastic lymphoma/leukaemia and other.
This year’s report presents several new analyzes of drug treatment based on data from the hospitals’ own systems. We look for the first time at drug treatment of Hodgkin lymphoma. In addition, we show results for drug treatment of large B-cell lymphoma and multiple myeloma. Helse Nord is still not included in the data capture, but will be as
soon as they can provide the Registry with data.
The incidence of Hodgkin lymphoma has been stable over the last 15 years and the prognosis is good. However, older patients have significantly poorer survival than younger patients do. The results indicate that the use of radiation therapy as part of the first-line treatment of Hodgkin lymphoma is decreasing compared to previous time
periods.
For most subgroups of non-Hodgkin lymphoma, the incidence has been stable over the last 15 years. Improved diagnostics, better chemotherapy regimens and the use of antibody (especially the anti-CD20 antibody rituximab) have led to increased survival in all subgroups of B-cell lymphomas. There are, however, variations in survival for patients over the age of 70. This years report includes an analysis showing the proportion of Hodgkin and non Hodgkin lymphoma patients who die within 180 days of diagnosis. The results vary.
This report focuses on the process of correct diagnostics of lymphoid malignancies. Histological type of non Hodgkin lymphoma is of great importance for the patients’ prognosis and the choice of treatment. Not all hospitals consult with the (nearest) university hospital before making a lymphoma diagnosis. Other quality indicators, such as staging and use of biopsy, are satisfactory.
Mature lymphoid leukaemia, which mainly consist of chronic lymphocytic leukaemias (CLL), have a stable incidence and an increasing 10-year relative survival. Increased survival is attributed to the increased use of chemoimmunotherapy. Staging according to Binet is used to assess whether the patient needs treatment, and this years report shows that reporting of stage has now reached an acceptable level. Mutational status and preferred IGHV gene are of significance, but the vast majority of patients diagnosed with mature lymphoid leukaemia have a good general health condition at the time of diagnosis and do not need treatment.
We have again chosen to include data from the Norwegian Patient Registry (NPR) in order to examine potential differences in the choice of treatment for CLL at diagnosis. This year we were able to use information about drug treatment from the hospitals’ own systems in addition to NPR. The analysis still shows variations between the different health trusts.
Another new analysis shows the proportion of multiple myeloma patients who receive chemotherapy less than 28 days before death. There is no consensus on what is a desirable proportion who receive myeloma treatment in the last phase of life. We have also looked at the proportion of multiple myeloma patients who are included in studies.
The analysis shows some variation based on residence. The incidence of myeloma has gradually increased since 2002. 5-year relative survival has increased from 37% to 70,5% in the same period. Prognoses are significantly better for younger patients. Use of FISH (Fluorescent in situ hybridization) analyses is nearing an acceptable level, while reporting of ISS (International Prognostic Staging) is incomplete.
The incidence of lymphoblastic lymphoma / leukaemia and Burkitt lymphoma / leukaemia has been stable since 2002. Survival has increased significantly, coinciding with the change in 2009-2010 of treatment guidelines for leukaemia/lymphoma however, the relative survival is rapidly declining, particularly in the older age group.