NEW YORK (Reuters Health) May 14 - Hodgkin lymphoma survivors are at high risk for cardiovascular disease, a Swedish study confirms. The risk is particularly high for patients treated for Hodgkin lymphoma before the age of 40 years and with a family history of heart disease.
In the April 15 issue of the International Journal of Cancer, the study team notes that "previous studies have shown increased cardiovascular mortality as late side effects of Hodgkin lymphoma patients." The aim of the current study, Dr. Anne Andersson of Umea University and colleagues explain, was to identify "stratifying risk factors for surveillance."
The investigators used the Swedish Cancer Registry to identify 6946 patients diagnosed with Hodgkin lymphoma between 1965 and 1995 and the Swedish Multigenerational Registry to identify a total of 17,858 first-degree relatives of the patients.
Among 4,635 Hodgkin lymphoma patients who survived one year or longer after diagnosis, 1,413 episodes of inpatient care for coronary artery disease, congestive heart failure, stroke and/or valvular disease in 698 individuals were recorded in the Swedish Hospital Discharge Registry.
Average follow up was 11.8 years and, according to the investigators, the standard incidence ratio (SIR) for cardiovascular disease was "increasing at the time of follow-up and the risk was higher for those treated for Hodgkin lymphoma before the age of 40."
The SIR for cardiovascular disease 10 to 19 years after Hodgkin lymphoma treatment was 3.06 for all Hodgkin lymphoma patients, and 5.53 in patients with a positive family history for cardiovascular disease.
For Hodgkin lymphoma survivors treated before age 40, the SIR for congestive heart failure 10 to 19 years after treatment was 3.45; it was 6.67 for those with a positive family history of cardiovascular disease, the report states.
For Hodgkin lymphoma survivors treated before the age 40 and followed for 20 years or longer, there was a 10-fold increase in risk for congestive heart failure. For this group, a positive family history of congestive heart failure yielded a SIR of 25.00.
Dr. Andersson and colleagues conclude, "A family history of cardiovascular disease could be particularly important for identifying patients at risk for early coronary artery disease and congestive heart failure."
The study, they add, "implicates in concert with two other large cohorts the need for cardiovascular intervention in this high risk group."
