Long-term cardiac morbidity in adolescent and young adult survivors of classical Hodgkin lymphoma: the British Columbia experience.

Journal: Haematologica

This study evaluated long-term cardiovascular disease (CVD) risks in adolescents and young adults (AYA, aged 16-39) who survived classic Hodgkin lymphoma (cHL) for at least two years after treatment with ABVD or equivalent chemotherapy, with or without radiotherapy (RT).

Over a median follow-up of 17 years, cHL survivors had a 2.9-fold increased risk of CVD compared to controls, including:

  • 5.2-fold higher risk of heart failure (HF)
  • 2.4-fold higher risk of ischemic heart disease (IHD)

Key findings include:

  • HF risk correlated with anthracycline chemotherapy exposure.
  • Elevated IHD risk was linked to radiotherapy (RT).
  • At 20 years post-treatment, cumulative incidence of HF was 4.3% versus 0.8% in controls.
  • Cumulative incidence of IHD was 8.3% versus 2.8% in controls.

Since 2005, PET scan-guided treatment has reduced RT use and was associated with a significantly lower 15-year IHD incidence, comparable to controls.

Overall, 20-year mortality remained higher in cHL survivors (5.0%) compared to controls (2.0%).

These findings highlight the need for tailored cardiovascular surveillance and risk reduction strategies in AYA cHL survivors.

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