1. Survival of lymphoma and beverages consumption; alcohol, tea and coffee:
Results from National Cancer Centre Singapore lymphoma cohort
1,2Yin Leng Lee, 1Kevin Tay, 3Soo Yong Tan, 1Leonard Tan, 1Richard Hong, 1Miriam Tao, 2Tam Cam Ha, 1Soon Thye Lim
1Department of Medical Oncology , 2Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore
and 3Department of Pathology, Singapore General Hospital
Abstract #2539
Study design Summary of key findings
• Total of 384 lymphoma patients recruited from January 2004 till December 2009.
• Alcohol, tea and coffee consumption data were collected using structured questionnaire.
• Patients were prospectively followed through till July 2012.
• Kaplan-Meier and Cox proportional hazard regression were use to examine lymphoma survival and
beverages intake.
• Estimated beverages hazard ratios were adjusted for demographic (age, gender, education level) and
clinical factors (LDH, ECOG, Ann Arbor stage).
• Increasing alcohol consumptions is associated with 2-fold decreased survival for all lymphoma (ptrend=0.004),
NHL (ptrend=0.033) and DLBCL ptrend=0.016).
• Female black tea (plog-rank=0.0063) and coffee (plog-rank=0.018) drinkers had 50% longer survival compared to
non-drinkers among all lymphoma.
• Survival difference in men who drank tea and/or coffee were not observed.
• To conclude, alcohol consumption led to shorter survival while tea and coffee intake among female results in
longer survival and these associations may need to be validated in a larger cohort.
Results
Table 1 Baseline demographics and clinical characteristics
Characteristics
Non-Hodgkin's lymphoma
(n=321)
Hodgkin lymphoma
(n=56)
n (%) n (%)
Age (median, range) 58 (19-90) 39 (18-78)
Gender, male 144 (44.9) 23 (41.1)
Race
Chinese 266 (82.9) 34 (60.7)
Malay 38 (11.8) 13 (23.2)
Indian 15 (4.7) 9 (16.1)
Others 2 (0.6) -
Alcoholic drinker, >1 drink/day 45 (14) 8 (14.3)
Tea drinker, >1 cup/day 105 (34.7) 15 (28.9)
Coffee drinker, >1 cup/day 184 (60.7) -
Haemaglobin, >12 g/dL 188 (58.9) 41 (73.2)
LDH, >380 U/L 131 (41.6) 27 (48.2)
Extranodal sites, >4 316 (98.8) 56 (100)
ECOG
0-2 300 (95.9) 55 (98.2)
3,4 13 (4.1) 1 (1.8)
Ann Arbor stage
Stage 1,2 174 (54.2) 51 (91.1)
Stage 3,4 147 (45.8) 5 (8.9)
Remission status
Complete response 228 (80.9) 44 (91.7)
Partial response 26 (9.2) 2 (4.1)
Stable disease 8 (2.8) 1 (2.1)
Progressive disease 20 (7.1) 1 (2.1)
Abbreviation: LDH – lactate dehydrogenase, ECOG – Eastern Cooperative Oncology Group
1Composite case (n=1) and lymphoma, not otherwise specified cases (n=6) were excluded from analysis
Table 2 Gender stratified, female tea and coffee consumptions adjusted hazard ratios
All teas
Type of teas
Red
Black
Green
Coffee
Lymphoma (n=170)* NHL (n=144)* DLBCL (n=84)*
plog-rank=0.64
ptrend=0.22
plog-rank=0.92
ptrend=0.52
plog-rank=0.0063
ptrend=0.69
plog-rank=0.48
ptrend=0.23
plog-rank=0.018
ptrend=0.44
plog-rank=0.39
ptrend=0.12
plog-rank=0.84
ptrend=0.28
plog-rank=0.03
ptrend=0.81
plog-rank=0.79
ptrend=0.23
plog-rank=0.0033
ptrend=0.23
plog-rank=0.43
ptrend=0.12
plog-rank=0.87
ptrend=0.70
plog-rank=0.50
ptrend=0.53
plog-rank=0.48
ptrend=0.19
plog-rank=0.12
ptrend=0.65
*Intake per day; none (reference group), <1, 1, >1 cup
Acknowledgement: This study was funded by the National Medical Research Council of Singapore as well as a grant from HSBC Trustee (Singapore) Limited as trustees of the Major John Long Trust Fund and the Chew Woon Poh Trust Fund
Figure 1 Overall survival of alcoholic drinkers among all lymphoma
Figure 2 Overall survival of alcoholic drinkers among all lymphoma by gender