LAUSR

diagnosis. If an observed condition had also been recorded prior to or within 1 year of cancer diagnosis, it was excluded. We used multivariable Poisson regression models adjusted for age, sex, race/ethnicity and year of diagnosis, to estimate incidence rate ratios (IRRs) for each condition comparing DLBCL survivors to each of the other cohorts. We also estimated the cumulative incidence of selected conditions over 10 years, accounting for death as a competing risk. We performed sensitivity analyses excluding patients with stem cell transplant (SCT), limiting comparison to a cohort that had uniformly received systemic chemotherapy, and restricting the analysis to a later survivorship period (years 5-10). Finally, we expanded the analysis to encompass 595 diagnosis codes for infections, autoimmune disease and immunodeficiencies, grouped into 18 clinical categories. Results: Survivor cohorts were similar with regard to frequency of healthcare encounters and median follow-up time [5.7-8.3 years]. DLBCL survivors had a significantly higher incidence of many immune-related conditions, including humoral deficiency [IRRs 13.5-18.3], autoimmune anemia [IRRs 7.4-13.4], and Sicca syndrome [IRRs 2.8-8.6]), which have been associated with DLBCL previously but here were observed with new onset during survivorship. DLBCL survivors also had elevated rates of infections, notably fungal pneumonias [IRRs 3.9-11.3], viral pneumonias [IRRs 3.9-6.6], and meningitis [IRRs 3.0-5.0]. Sensitivity analyses produced similar results. Finally, a broader assessment of infections, autoimmune diseases and immunodeficiencies grouped by clinical category found widely increased risk among DLBCL survivors (Figure 1). Conclusion: These findings, from a large, population-based cohort, show that immune-related conditions in DLBCL survivors are wideranging, and increased risk for these conditions is long-lasting. These data highlight a need to understand the mechanisms of immune dysfunction and to define predictors of clinical risk among DLBCL survivors.