Cardiovascular Diseases And Psychiatric Disorders During The Diagnostic Workup Of Suspected Hematological Malignancy
Received 2 June 2019
Accepted for publication 30 October 2019
Published 2 December 2019 Volume 2019:11 Pages 1025—1034
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 2
Editor who approved publication: Professor Eyal Cohen
Qianwei Liu,1 Therese ML Andersson,2 Anna Jöud,3,4 Qing Shen,2 Maria EC Schelin,3,5 Patrik KE Magnusson,2 Karin E Smedby,6 Fang Fang1
1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 3Lund University, Department of Clinical Sciences Lund, Orthopaedics, Lund, Sweden; 4Lund University, Department of Laboratory Medicine, Occupational and Environmental Medicine, Lund, Sweden; 5Institute for Palliative Care, IKVL, Lund University and Region Skåne, Lund, Sweden; 6Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
Correspondence: Fang Fang
Institute of Environmental Medicine, Karolinska Institutet, Box 23109, 104 35, Stockholm, Sweden
Tel +46 8 52486131
Background: Little attention has been given to the risk of cardiovascular and psychiatric comorbidities during the clinical evaluation of a suspected hematological malignancy.
Methods: Based on Skåne Healthcare Register, we performed a population-based cohort study of 1,527,449 individuals residing during 2005–2014 in Skåne, Sweden. We calculated the incidence rate ratios (IRRs) of cardiovascular diseases or psychiatric disorders during the diagnostic workup of 5495 patients with hematological malignancy and 18,906 individuals that underwent a bone marrow aspiration or biopsy or lymph node biopsy without receiving a diagnosis of any malignancy (“biopsied individuals”), compared to individuals without such experience (i.e., reference).
Results: There was a higher rate of cardiovascular diseases during the diagnostic workup of patients with hematological malignancy (overall IRR, 3.3; 95% CI, 2.9 to 3.8; greatest IRR for embolism and thrombosis, 8.1; 95% CI, 5.2 to 12.8) and biopsied individuals (overall IRR, 4.9; 95% CI, 4.6 to 5.3; greatest IRR for stroke, 37.5; 95% CI, 34.1 to 41.2), compared to reference. Similarly, there was a higher rate of psychiatric disorders during the diagnostic workup of patients with hematological malignancy (IRR, 2.1; 95% CI, 1.5 to 2.8) and biopsied individuals (IRR, 3.1; 95% CI, 2.9 to 3.4). The rate increases were greater around the time of diagnosis or biopsy, compared to thereafter, for both outcomes.
Conclusion: There were higher rates of cardiovascular diseases and psychiatric disorders during the diagnostic workup of a suspected hematological malignancy, regardless of the final diagnosis.
Keywords: hematological malignancy, cardiovascular diseases, psychiatric disorders, diagnostic workup
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