Adults who have survived Hodgkin lymphoma for at least 5 years may face significantly elevated long-term health risks and cancer and noncancer mortality, according to a new study led by researchers at The University of Texas MD Anderson Cancer Center. The retrospective population-based study, published in JAMA Network Open, was led by Bryan Valcarcel, MD, Instructor, and Luis Malpica Castillo, MD, Associate Professor, both of the Department of Lymphoma & Myeloma at MD Anderson.
The researchers analyzed data from 2000 to 2017, including more than 20,000 survivors of Hodgkin lymphoma with an average age of 36 years. Eligible patients were 20 years and older at the time of their initial diagnosis of Hodgkin lymphoma. They reported 2,899 deaths occurred among survivors, whereas in the general population 1,481 deaths would have been expected. While the majority of deaths were related to cancer, noncancer adverse health conditions also were increased in the survivors of Hodgkin lymphoma.
“Thanks to advances in treatment, patients are living longer. However, our findings confirm comprehensive survivorship care focused on cardiovascular health, secondary cancers, and other chronic conditions is important to improve long-term survival outcomes,” Dr. Malpica said.
In addition to the elevated risk of cancer mortality in 5-year survivors, researchers found the increased risk was also present in those who had survived at least 10 years. However, noncancer causes represented the largest cumulative mortality burden in these long-term survivors, followed by other cancers, cardiovascular disease, and recurrence of Hodgkin lymphoma. Overall, the highest relative risks were seen among younger adults diagnosed between ages 20 and 39 years, and among several racial and ethnic minority groups. Mortality rates were lower among patients diagnosed in recent years, reflecting ongoing progress in treatment.
The study’s findings reinforce the need for ongoing surveillance and personalized survivorship strategies
DISCLOSURE:This research was supported by the American Society of Hematology—Amos Institute for Medical Faculty Development Award, Birdies Fore Logan, and the Robert A. Winn Clinical Investigator Leadership Award. For full disclosures of the study authors, visit jamanetwork.com
