TY - JOUR
T1 - High burden of subsequent malignant neoplasms and cardiovascular disease in long-term Hodgkin lymphoma survivors
AU - de Vries, Simone
AU - Schaapveld, Michael
AU - van Nimwegen, Frederika A.
AU - Jóźwiak, Katarzyna
AU - Lugtenburg, Pieternella J.
AU - Daniëls, Laurien A.
AU - Roesink, Judith M.
AU - van der Maazen, Richard W. M.
AU - Kok, Wouter E. M.
AU - Aleman, Berthe M. P.
AU - van Leeuwen, Flora E.
PY - 2018
Y1 - 2018
N2 - Hodgkin lymphoma (HL) patients are at an increased risk of late adverse treatment effects. While published studies focussed on the risk of either subsequent malignant neoplasms (SMNs) or cardiovascular disease (CVD), we examined the combined burden from SMN and CVD. In 2908 5-year HL survivors treated between 1965 and 2000, the burden from SMN and/or CVD was assessed using cumulative incidences (CIs) and the mean cumulative count (MCC). We identified 888 SMNs and 1153 CVDs in 1247 patients (median follow-up 22 years). At 40 years, the CI for developing either SMN or CVD was 68% and the CI for developing both SMN and CVD was 17%, and an average of 1.2 events per patient (MCC) was observed. HL patients who developed a solid malignancy had similar 15-year risks to develop another subsequent malignancy or CVD (15%), whereas patients who developed a CVD after HL had a higher 15-year risk to develop another CVD compared with a subsequent malignancy (46 vs 15%). Radiotherapy was the strongest risk factor for developing both SMN and CVD in multivariable Cox regression models. Treating physicians should be aware of the increased risk of both SMN and CVD in patients treated for HL until 2000.British Journal of Cancer advance online publication, 30 January 2018; doi:10.1038/bjc.2017.476 www.bjcancer.com
AB - Hodgkin lymphoma (HL) patients are at an increased risk of late adverse treatment effects. While published studies focussed on the risk of either subsequent malignant neoplasms (SMNs) or cardiovascular disease (CVD), we examined the combined burden from SMN and CVD. In 2908 5-year HL survivors treated between 1965 and 2000, the burden from SMN and/or CVD was assessed using cumulative incidences (CIs) and the mean cumulative count (MCC). We identified 888 SMNs and 1153 CVDs in 1247 patients (median follow-up 22 years). At 40 years, the CI for developing either SMN or CVD was 68% and the CI for developing both SMN and CVD was 17%, and an average of 1.2 events per patient (MCC) was observed. HL patients who developed a solid malignancy had similar 15-year risks to develop another subsequent malignancy or CVD (15%), whereas patients who developed a CVD after HL had a higher 15-year risk to develop another CVD compared with a subsequent malignancy (46 vs 15%). Radiotherapy was the strongest risk factor for developing both SMN and CVD in multivariable Cox regression models. Treating physicians should be aware of the increased risk of both SMN and CVD in patients treated for HL until 2000.British Journal of Cancer advance online publication, 30 January 2018; doi:10.1038/bjc.2017.476 www.bjcancer.com
U2 - https://doi.org/10.1038/bjc.2017.476
DO - https://doi.org/10.1038/bjc.2017.476
M3 - Article
C2 - 29381685
SN - 0007-0920
VL - 118
SP - 887
EP - 895
JO - British journal of cancer
JF - British journal of cancer
IS - 6
ER -