In a nutshell
The authors looked at the relationship between heart failure and different treatments for Hodgkin Lymphoma. This study concluded that the risk of heart failure increased with increasing radiation doses and the use of chemotherapy containing anthracyclines (such as doxorubicin).
Some background
Hodgkin lymphoma (HL) has high 10-year survival rates (over 80%), but treatments for HL have been linked to developing cardiovascular diseases later in life. Previous studies have shown that both radiation to the chest/heart area and anthracycline chemotherapy are associated with an increased risk of coronary heart disease, valvular heart disease, and heart failure. Increasing doses of radiation have been associated with increasing risks of coronary and valvular heart disease. It is not clear whether there is a relationship between radiation dose and risk of heart failure.
Methods & findings
This study examined the risk of heart failure in patients treated with radiation and/or anthracycline chemotherapy. This study included the records of 369 patients who had survived HL for at least 5 years. 91 of these patients developed heart failure and 278 did not. Different doses of radiation were compared: low (0-15 Gy), medium (16-20 Gy), and high (21 Gy or more).
Patients who were treated with higher doses of radiation therapy to their chest/heart were significantly more likely to develop heart failure later. The 25-year risk of developing heart failure with low-dose radiation was 4.4%. The risk with medium dose was 6.2%. The risk with high dose was 13.3%.
Patients who were treated with anthracycline-based chemotherapy were 2.83 times more likely to develop heart failure. The 25-year risk of developing heart failure in these patients was 11.2% with low-dose radiation, 15.9% with medium-dose, and 32.9% with high dose radiation.
The bottom line
This study concluded that patients who received radiotherapy to the heart or chemotherapy containing anthracyclines are at significantly higher risk for developing heart failure later in life.
The fine print
This study recruited patients who received treatment between 1965 and 1995. The doses of radiation and chemotherapy that are received by patients today are significantly lower than the doses received between 1965 and 1995.
What’s next?
Talk to your doctor about other risk factors for heart failure and how to reduce them.
Published By :
Blood
Date :
Jan 31, 2017
