We are delighted to announce a comparison cohort for the Haematological Malignancy Research Network (HMRN). This cohort allows us to compare the health of patients with blood cancer to similar people in the general population who are cancer-free. These comparisons are helping us find out more about how blood cancers (leukaemias, lymphomas, multiple myeloma) relate to other conditions and illnesses.
To create the cohort, we matched 18,000 patients with blood cancer or related disorders, on age and sex, to ten randomly selected individuals from the NHS Central Register (180,000 controls in total). Looking at the comparison cohort and patient cohort side-by-side means that we can track patterns of co-morbidities and healthcare activity; uncovering novel associations and highlighting important connections and areas where extra monitoring and care may be needed.
HMRN now has two large cohorts feeding in to its research on blood cancers (leukaemias, lymphomas, myelomas):
Since 2004 we have tracked all patients (40,000 approx.) diagnosed with a haematological malignancy within HMRN’s catchment population of around 4 million people through local clinical systems. They are then routinely linked to national databases on deaths, cancers, hospital admissions, and hospital outpatient attendances (Hospital Episode Statistics, HES). The HMRN population is broadly representative of the UK as a whole and clinical practice across the HMRN region adheres to national guidelines. All patients are included regardless of age, treatment intent, trial entry, or whether they are NHS or private patients. About 2,500 new diagnosis are made each year. This vital information is disseminated to researchers, clinicians, patients and commissioners to give them the best picture of the burden of these diseases across the population as a whole (www.hmrn.org/about)
The new comparison cohort is made up of people from the same area, with the same characteristics (age and sex), as people in the cancer cohort. Their data are linked by NHS Digital to nationwide administrative databases for deaths, cancer registrations and hospital episode statistics (HES) just as the patient cohort is. In this way the health of the cancer patients can be compared to that of unaffected individuals in the general population. This is enabling new research examining associations with other cancers and diseases, as well as short and long-term levels of hospital activity.
To create the new cohort, all patients newly diagnosed with a blood cancer between 2009 and 2015 (18,127 patients) were matched on year of birth, sex and residency in the HMRN study area to 10 randomly selected unaffected individuals (181,270 people). This very large matching process was a first for NHS Digital, the national provider of information, data and IT systems for the NHS.
The new cohort has already been used successfully to look at the relationship between immune system problems and the development of mature B-cell malignancies and autoimmune conditions:
Our population-based cohort main strengths are:
“Embedding high-quality, population-based, epidemiological, clinical and biological research within the framework of NHS clinical practice, HMRN’s multifaceted cohorts have not been replicated elsewhere in the world. The incorporation of a new general-population cohort, allows us to compare the health of those who have blood cancer to those who do not – both in the years before cancer is diagnosed and the years after. Thus far, many of the findings have been striking and unexpected. We are currently examining longer term health (survivorship); looking, for example, to see whether the health of patients successfully treated for cancer ever returns to the level it would have been, had they not had cancer”