Long-Term Cardiac Risk After Hodgkin Lymphoma

Risk increased threefold to fivefold for at least 25 years

THURSDAY, March 8 (HealthDay News) -- Survivors of Hodgkin lymphoma have a threefold to fivefold increase in the risk of developing cardiovascular diseases in the decades after treatment, according to a study in the March 1 issue of Blood.

Flora E. van Leeuwen, Ph.D., of the Netherlands Cancer Institute in Amsterdam, and colleagues examined the long-term risk of cardiovascular disease in 1,474 survivors of Hodgkin lymphoma who were younger than 41 years of age at treatment.

After a median follow-up of 18.7 years, the researchers found that the survivors had a higher risk of myocardial infarction and congestive heart failure (standardized incidence ratio, 3.6 and 4.9, respectively) compared with the general population. The risks of all cardiovascular diseases combined continued for at least 25 years, particularly in younger patients. Mediastinal radiotherapy was associated with a twofold to sevenfold increase in the risk of myocardial infarction, angina pectoris, congestive heart failure and valvular disorders. The addition of anthracycline chemotherapy further increased the risk of the latter two conditions, the report indicates.

"In conclusion, risks of several cardiovascular diseases are threefold to fivefold increased in survivors of Hodgkin lymphoma compared with the general population, even after prolonged follow-up, leading to increasing absolute excess risks over time," van Leeuwen and colleagues write. "Anthracyclines further increase the elevated risks of congestive heart failure and valvular disorders from mediastinal radiotherapy."

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