Evidence mapPaperPMID 41408704Full record

ArticleActa oncologica (Stockholm, Sweden)2025

Continuous tobacco smoking increases mortality in diffuse large B-cell lymphoma but not follicular lymphoma, a Finnish population-based study.

Taina Reunamo, Erika Alanne, Toni Mikkola, Antti Karlsson, Antti Ellonen, Tarja Laitinen, Maarit Bärlund, Pia Österlund, Heikki Minn, Sirpa Leppä and 2 more

Abstract read
In one paragraph

Article in Acta oncologica (Stockholm, Sweden), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Taina ReunamoTurku University Hospital and University of Turku, Department of Oncology, Turku, Finland; Wellbeing services county of Southwest Finland, Turku, Finland. taina.reunamo@varha.fi.ORCID 0009-0005-1675-1436
Erika AlanneTurku University Hospital and University of Turku, Department of Oncology, Turku, Finland; Wellbeing services county of Southwest Finland, Turku, Finland; Western Finland Cancer Centre, Turku, Finland.ORCID 0000-0003-1925-0192
Toni MikkolaDepartment of Oncology and Tays Cancer Center, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.ORCID 0009-0009-6706-4053
Antti KarlssonUniversity of Turku, Turku, Finland; Pihlajalinna Oyj, Tampere, Finland.ORCID 0000-0003-1556-3351
Antti EllonenTurku University Hospital and University of Turku, Department of Oncology, Turku, Finland; Wellbeing services county of Southwest Finland, Turku, Finland.ORCID 0000-0001-5902-6182
Tarja LaitinenInstitute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland.ORCID 0009-0003-7062-8629
Maarit BärlundDepartment of Oncology and Tays Cancer Center, Tampere University Hospital, Wellbeing; Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.ORCID 0000-0002-1469-5654
Pia ÖsterlundDepartment of Oncology and Tays Cancer Center, Tampere University Hospital, Wellbeing; Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.ORCID 0000-0002-7124-3515
Heikki MinnUniversity of Turku, Turku, Finland.ORCID 0000-0002-5878-4333
Sirpa LeppäUniversity of Helsinki, Faculty of Medicine, Department of Oncology and Research Programs Unit, Helsinki, Finland; Helsinki University Hospital Comprehensive Cancer Centre, Helsinki, Finland.ORCID 0000-0002-8265-511X
Sirkku JyrkkiöTurku University Hospital and University of Turku, Department of Oncology, Turku, Finland; Wellbeing services county of Southwest Finland, Turku, Finland.ORCID 0000-0001-6826-9354
Eetu HeerväTurku University Hospital and University of Turku, Department of Oncology, Turku, Finland.ORCID 0000-0002-6134-1170

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeTobacco smoking was prognostic in B-cell lymphomas in the pre-rituximab era, but the association with modern treatment, stage, subtypes, and survival outcomes remains unclear. Patient/material and methods: All patients with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) from Turku and Tampere University Hospitals 2009-2019 were identified. Population-based data from electronic medical records included demographics, tumour histology, Ann Arbor staging, and treatments. Smoking status was extracted with a deep learning-based natural language processing algorithm. Kaplan-Meier overall survival (OS) estimates and adjusted hazard ratios (HRs) were calculated.

resultsWith a median follow-up of 96 months, 1,258 patients with DLBCL and 529 with FL were included. In DLBCL, the 5-year OS rate was 61%, 53%, and 45% among never, former, and persistent smokers, respectively. Persistent smoking remained an independent prognostic factor for shorter OS, HR 1.27 (95% confidence interval 1.10-1.60) after adjustment for comorbidities and completed treatment. The prognosis of FL was indolent with no difference in OS regardless of smoking status, with 5-year OS rates of 79%, 75%, and 74% among never, former, and persistent smokers, respectively. Smokers were younger at diagnosis, while other baseline demographics were similar. No differences in the systemic therapy use were observed between the different smoking categories in both FL and DLBCL.

interpretationOverall and lymphoma-specific mortality is increased in persistent smokers with DLBCL compared with never smokers. Smoking prevention and cessation support remains of utmost importance.

Indexed as

Lymphoma, FollicularLymphoma, Large B-Cell, DiffuseTobacco SmokingAdultAgedAged, 80 and overFemaleFinlandFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedPrognosisRetrospective StudiesSurvival Rate

Identifiers

PMID41408704
PMCPMC12746680

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.