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July 25, 2022
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Cardiovascular disease, not cancer, top cause of death among Hodgkin lymphoma survivors

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Patients with early-stage classic Hodgkin lymphoma and other neoplasms exhibited higher risk for cardiovascular disease-associated mortality compared with cancer-associated mortality later in life, according to study results.

The findings, published in Cancer, suggest more effective measures are needed to reduce the risk for cardiovascular disease-associated mortality in this patient population, researchers noted.

Rationale and methods

Research is lacking on the progressive trend of cardiovascular disease mortality among patients with classic Hodgkin lymphoma, according to study background.

“We conducted this study because cardiovascular disease may be the most common nonmalignant long-term complication and a prevalent cause for nonmalignant death following treatment in [Hodgkin lymphoma] survivors,” Caiwen Ou, MD, PhD, of Southern Medical University in Guangzhou, China, said in a press release.

The multicenter cohort trial included 15,889 children and adults (55.3% aged younger than 35 years at diagnosis; 55% male) diagnosed with classic Hodgkin lymphoma between 1983 and 2015.

The researchers assessed the proportional mortality ratio, cumulative incidence of cause-specific mortality accounting for competing risk, standard mortality ratio and absolute excess risk between 1983 and 1992, 1993 and 2002, and 2003 and 2015.

Key findings

Results showed patients with stage I or stage II disease exhibited a higher risk for cardiovascular disease mortality compared with the general population for nearly all follow-up intervals, with an absolute risk of 48.5 for cardiovascular disease among patients with stage I disease.

The proportional mortality ratio for cardiovascular disease exceeded that for classic Hodgkin lymphoma at 60 months among patients with stage I disease and 120 months for patients with stage II disease.

Moreover, the cumulative incidence of cardiovascular disease mortality surpassed that of classic Hodgkin lymphoma and other neoplasms throughout time.

Although the risk for classic Hodgkin lymphoma-associated mortality decreased sharply in recent decades, the risk for cardiovascular disease-associated mortality decreased slowly or remained unchanged for certain patients.

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