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Increased Risk of Hip Fracture in Patients with Lymphoma, a Swedish Population Study of 37,236 Lymphoma Patients

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Abstract

Increased bone loss has been noted in lymphoma patients; however, the incidence of hip fracture is not known. The aim of our study was to explore the risk for hip fracture in patients with lymphoma compared with the entire Swedish population. The risk of hip fracture was determined in a retrospective population cohort study of adult Swedish lymphoma patients (n = 37,236), diagnosed 1995–2015 and compared with the entire Swedish population during the same period. The incidence of hip fracture in lymphoma patients was higher in women than in men, increased by age, and decreased by calendar year as also demonstrated in the total population. 2.2% of the men and 4.7% of women with lymphoma sustained a hip fracture. For the total group of females, the hazard ratio (HR) was 1.19 (95% CI 1.11–1.28) and for men, the hazard ratio was 1.06 (95% CI 0.97–1.17) compared with the Swedish population. The HR for hip fracture (2016) was 2.80 (95% CI 1.20–6.53), 2.04 (95% CI 1.30–3.20), 1.56 (95% CI 1.21–2.01), 1.08 (95% CI 0.89–1.30), and 1.07 (95% CI 0.92–1.25) in females aged 40, 50, 60, 70, and 80 years, respectively. Corresponding figures for men were not significant in 2016. Unmarried men with lymphoma had a two times higher risk for hip fracture (HR 2.02 95% CI 1.63–2.50) compared with married men. Patients with lymphoma had an increased risk of hip fracture, especially younger women and unmarried men. The incidence of hip fracture is decreased by calendar year in the lymphoma patients and the entire Swedish population.

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Acknowledgements

The research was supported by the ALF LUA research grant in Gothenburg.

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Authors and Affiliations

  1. Section of Hematology and Coagulation, Department of Internal Medicine, Institute of Medicine, Sahlgrenska University Hospital, Sahlgrenska Academy,, University of Gothenburg, Bruna Stråket 5, 413 45, Gothenburg, Sweden

    Peter Johansson, Hallgerdur Lind Kristjansdottir, Ana Jakir & Catharina Lewerin

  2. McKillop Health Institute, Australian Catholic University, Melbourne, Australia

    Helena Johansson

  3. Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden

    Helena Johansson

  4. Center for Bone and Arthritis Research (CBAR), Departments of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Dan Mellström

  5. Department of Geriatric Medicine, Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Dan Mellström

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  1. Peter Johansson
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  2. Hallgerdur Lind Kristjansdottir
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Correspondence to Peter Johansson.

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Conflict of interest

Peter Johansson, Hallgerdur Lind Kristjansdottir, Helena Johansson, Ana Jakir, Dan Mellström, and Catharina Lewerin have no conflict of interest.

Human and Animal Rights and Informed Consent

This study was performed in accordance with the Declaration of Helsinki after ethical approval by the Research Ethics Board at the University of Gothenburg, Sweden (no 202-16).

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Johansson, P., Lind Kristjansdottir, H., Johansson, H. et al. Increased Risk of Hip Fracture in Patients with Lymphoma, a Swedish Population Study of 37,236 Lymphoma Patients. Calcif Tissue Int 106, 591–598 (2020). https://doi.org/10.1007/s00223-020-00674-7

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