Hodgkin lymphoma survivors at high risk of cardiovascular diseases

People with Hodgkin lymphoma have a high risk for various cardiovascular diseases for decades after their initial diagnosis, according to a retrospective cohort study.

After 35 or more years of treatment, they were four to six times more likely to have coronary heart disease (CHD) or heart failure compared with the general population. The 40-year cumulative incidence of cardiovascular diseases was 49.5 percent.

Lead researcher Frederika A. van Nimwegen, MSc, of the Department of Epidemiology at the Netherlands Cancer Institute in Amsterdam, and colleagues published their findings online in JAMA Internal Medicine on April 27.

Although more than 80 percent of people with Hodgkin lymphoma survive for 10 years or more, the researchers noted treatments for the disease are associated with adverse effects.

This study included 2,524 patients treated for Hodgkin lymphoma in five Dutch university hospitals or cancer centers from Jan. 1, 1965 through Dec. 31, 1995. All patients had been diagnosed with Hodgkin lymphoma at younger than 51 years and had survived for at least five years. The median age of diagnosis was 27.3 years and 54.3 percent of patients were males.

After a median follow-up of 20.3 years, researchers found 1,713 cardiovascular events in 797 patients. More than half of the patients (51.4 percent) had two or more cardiovascular events. CHD was the most common cardiovascular disease and was followed by valvular heart disease (VHD) and heart failure.

Patients who received treatment before 25 years of age had the highest cumulative incidence of cardiovascular diseases.

The 40-year cumulative incidence of any cardiovascular disease was 54.6 percent for patients treated with mediastinal radiotherapy and 24.7 percent for patients not treated with mediastinal radiotherapy or anthracyclines.

In addition, the 40-year cumulative incidences for CHD and VHD as first events were 22.9 percent and 25.9 percent, respectively.