In a nutshell
This study examined the long-term risk of cardiovascular disease (CVD, heart and blood vessel disease) in treated Hodgkin lymphoma patients. The authors concluded that the risk of CVD was higher in Hodgkin lymphoma survivors compared to the general population. The average time between treatment and CVD was 19 years.
Some background
Chemotherapy and radiation treatment have greatly increased long-term survival rates in patients with Hodgkin lymphoma. These therapies are also associated with an increased risk of long-term complications. These include second cancers and CVD.
Radiation to the chest area increases CVD risk, as well as the risk of breast or lung cancer. Anthracyclines (a type of chemotherapy, such as doxorubicin) have been associated with an increased risk of CVD in many types of cancer. Many Hodgkin lymphoma patients are now treated with chemotherapy combinations that include anthracyclines. Previous studies, though, have not compared the risk of CVD following Hodgkin lymphoma treatment and the general population.
Methods & findings
The current study examined the risk of CVD in 5-year survivors of Hodgkin lymphoma. The records of 1474 patients were examined. Patients had been treated during the period between 1965 and 1995. Standard radiation doses and schedules were changed during this time period.
Most patients (1241) were treated with radiation to the chest. 28% of patients were treated with radiation alone. 38% were treated with radiation and chemotherapies not including an anthracycline. 29% were treated with radiation and chemotherapy with an anthracycline. Average follow-up was 18.7 years.
619 CVDs or CVD events (such as a heart attack) were noted in 354 patients at least 5 years after diagnosis. Diseases of the heart valves, heart attacks, and angina (chest pain) were the most common. The risk of heart attack and congestive heart failure (CHF; when the heart does not pump blood as well as it should) was significantly higher in Hodgkin lymphoma survivors compared to the general population.
Radiation to the chest area increased the risk of angina 4.85-fold and the risk of CHF 7.37-fold. Anthracyclines signficantly added to the risk from radiation for CHF and heart valve diseases.
Higher rates of heart attack, angina, and CHF were noted in patients who were treated at a younger age (20 years or less).
The bottom line
This study concluded that the long-term risk of CVD is increased in Hodgkin lymphoma survivors.
Published By :
Blood
Date :
Mar 01, 2007
