Hodgkin Lymphoma Survivors Face Risk of Heart Problems Later in Life

Patients who survived Hodgkin lymphoma (HL) early in life are nearly five times as likely to have severe and potentially life-threatening cardiovascular health conditions by age 50, according to a study published in The Lancet Oncology.

Nickhill Bhakta, MD, of the Department of Oncology at St. Jude Children’s Research Hospital in Memphis, Tennessee, and authors collected data between 1971 and 2014 from 670 cancer patients who survived ≥10 years and reached 18 years of age. Their outcomes were compared with 272 matched controls.

By 50 years of age, about 46 percent of the cancer survivors had experienced at least one serious heart problem, compared with about 16 percent in the control group.

At 50 years of age, the cumulative incidence of HL survivors experiencing at least one grade 3-5 cardiovascular condition was 45.5 percent (95% CI 36.6-54.3), compared with 15.7 percent among the control group (95% CI 7.0-24.4).

Overall, HL survivors experienced a cumulative burden of 430.6 grade 1-5 cardiovascular conditions (95% CI 380.7-480.6) and 100.8 grade 3-5 cumulative cardiovascular conditions (95% CI 77.3-124.3) per 100 survivors. These numbers were higher than the control cohort (227.4 [95% CI 192.7-267.5] and 17 [95% CI 8.4-27.5], respectively). Myocardial infarction and structural heart defects were major contributors to grade 3-5 cardiovascular burden.

A limitation of the study is that it may have underestimated the mortality risk associated with cancer treatment. In addition, more recent patient cohort outcomes may be different, as doctors treating these patients may have been more aware of cardiac complications associated with radiation and chemotherapy, and thus limit these exposures as much as possible.

Sources: Bhakta N, Liu Q, Yeo F, et al. Cumulative burden of cardiovascular morbidity in paediatric, adolescent, and young adult survivors of Hodgkin’s lymphoma: an analysis from the St Jude Lifetime Cohort Study. Lancet Oncol. 2016 July 25. [Epub ahead of print]; Reuters, August 26, 2016.