Key result
Polypharmacy linked to ~40% higher risk of death, hospitalization, and severe infection in lymphoid cancer.
Why the study?
Polypharmacy results from multimorbidity and may limit treatment options in patients with lymphoid cancer, but its clinical impact required investigation.
Does polypharmacy predict overall survival, hospitalization, and severe infection in patients with lymphoid cancer?
Cohort (n=46,803)
Does polypharmacy predict overall survival, hospitalization, and severe infection in patients with lymphoid cancer?
A 1-year prediagnostic medication history summarized as the number of medications is a strong, independent prognostic marker for survival, hospitalization, and infection in patients with lymphoid cancer.
This is the authors' abstract. We don't add key points for this paper.
Polypharmacy is a result of multimorbidity and may limit treatment options in patients with lymphoid cancer (LC). To investigate the clinical impact of polypharmacy, we gathered a prediagnostic 1‐year medication history from the Danish prescription register for 46,803 newly diagnosed patients with six lymphoma subtypes, chronic lymphocytic leukemia, and multiple myeloma (MM). Medication was grouped into individual drug classes ( n = 79), polypharmacy, and the number of prescription medications and correlated with overall survival (OS), hospitalization, and severe infection. Adjusting for age, sex, and multiple testing, we demonstrated associations between 39 drug classes and OS, 29 drug classes and hospitalization, and 27 drug classes and severe infection. Although polypharmacy (<5 vs. ≥5) was associated with adverse outcomes (hazard ratio [HR] 1.4 for OS, hospitalization, and severe infection; P < 0.001), the number of medications (0–3 vs. 4–7 vs. 8–11 vs. >11) gradually stratified OS (HR 1.0 vs. 1.2 vs. 1.4 vs. 1.9, respectively; P < 0.001), hospitalization (HR 1.0 vs. 1.3 vs. 1.4 vs. 1.9, respectively; P < 0.001), and severe infection (HR 1.0 vs. 1.2 vs. 1.5 vs. 1.9, respectively; P < 0.001) in multivariable analyses adjusted for age, sex, comorbidity, and prognostic indices. Lastly, the time to next treatment for Hodgkin lymphoma, mantle cell lymphoma, and MM was gradually shorter with an increasing number of medications (P < 0.001). In conclusion, a 1‐year medication history summarized as the number of medications is a strong, independent prognostic and predictive marker that should be considered as a key baseline characteristic in randomized clinical trials and in clinical practice for LC patients.
Answers are grounded in this paper and cite their sources.
Polypharmacy should not yet change practice in lymphoid cancer; leaves open whether deprescribing improves survival or reduces infection.
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Brieghel et al. (2025) conducted a cohort in Lymphoid cancer (n=46,803). Polypharmacy (≥5 medications) vs. <5 medications was evaluated on Overall survival, hospitalization, and severe infection (HR 1.4, p=<0.001). Polypharmacy (≥5 vs <5 medications) independently predicted worse overall survival, hospitalization, and severe infection (HR 1.4; P<0.001) in newly diagnosed lymphoid cancer patients.
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