{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:44:24Z","timestamp":1790217864714,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U01 CA195568"],"award-info":[{"award-number":["U01 CA195568"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Newly diagnosed patients with non\u2010Hodgkin lymphoma (NHL) often have a history of other diseases, and these comorbidities can impact patient treatment and management options, as well as overall survival (OS). We developed the Lymphoma Epidemiology of Outcomes (LEO) comorbidity index (LCI) as a sum of 10 comorbidities adapted from the Self\u2010Report\u2010Generated Charlson Comorbidity Index (SRG\u2010CCI) for use in the LEO cohort, a national prospective study of newly diagnosed NHL. Of the 5502 participants with self\u2010reported comorbidity data, 3107 (56.4%) were male and the mean age at diagnosis was 60.9\u00a0years (range, 18\u201399\u00a0years). The LCI ranged from 0 to 6, with 48.6% having 0, 30.2% having 1, 21.2% having 2 or more comorbidities. With a median follow\u2010up of 62.4\u00a0months among surviving participants, 2099 patients had an event and 1219 died. Continuous LCI similarly predicted both 1\u2010year mortality (c\u2010statistic\u00a0=\u00a00.654) and OS (c\u2010statistic\u00a0=\u00a00.655), while it showed a weaker but still statistically significant predictive ability for lymphoma\u2010specific (c\u2010statistics\u00a0=\u00a00.617) and event\u2010free (c\u2010statistic\u00a0=\u00a00.574) survival. Participants with 1 (HR\u00a0=\u00a01.21, 95% CI 1.05\u20131.39) and 2+ (HR\u00a0=\u00a01.80, 95% CI 1.56\u20132.08) comorbidities had inferior OS compared to those with no comorbidities after adjustment for age and sex (c\u2010statistic\u00a0=\u00a00.654), and performance strengthened after adjustment for the International Prognostic Index (c\u2010statistic\u00a0=\u00a00.672). LCI predicted OS most strongly in marginal zone (c\u2010statistics\u00a0=\u00a00.748) and weakest in T\u2010cell (c\u2010statistic\u00a0=\u00a00.579) lymphoma. The cumulative incidence of death due to lymphoma, lymphoma treatment, and other causes all increased with increasing comorbidities, with the greatest increase observed for death due to other causes. The LCI performs comparable to other published comorbidity indices, supporting its use in the LEO cohort to better model real\u2010world outcomes and more generally providing an approach to implementing comorbidity indices in cancer survivorship cohorts.<\/jats:p>","DOI":"10.1002\/hon.70137","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T01:09:18Z","timestamp":1759885758000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adaptation and Performance of the Self\u2010Report\u2010Generated Charlson Comorbidity Index in the Lymphoma Epidemiology of Outcomes (LEO) Cohort"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-178X","authenticated-orcid":false,"given":"James R.","family":"Cerhan","sequence":"first","affiliation":[{"name":"Division of Epidemiology Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Sokolova","sequence":"additional","affiliation":[{"name":"Division of Epidemiology Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliott J.","family":"Cahn","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials and Biostatistics Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1215-4210","authenticated-orcid":false,"given":"Mazie","family":"Tsang","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology Department of Medicine Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4964-167X","authenticated-orcid":false,"given":"Christopher S.","family":"Strouse","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone and Marrow Transplantation Department of Internal Medicine University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6769-6872","authenticated-orcid":false,"given":"Michelle A. T.","family":"Hildebrandt","sequence":"additional","affiliation":[{"name":"Department of Lymphoma and Myeloma The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8915-3163","authenticated-orcid":false,"given":"Allison C.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology Department of Medicine Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5009-4808","authenticated-orcid":false,"given":"Andrew L.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7977-6909","authenticated-orcid":false,"given":"David L.","family":"Jaye","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7813-1551","authenticated-orcid":false,"given":"Peter","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2723-6481","authenticated-orcid":false,"given":"Jonathon B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0459-6609","authenticated-orcid":false,"given":"Brad S.","family":"Kahl","sequence":"additional","affiliation":[{"name":"Division of Oncology Washington 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