A population-based study of cardiac morbidity among Hodgkin lymphoma patients with preexisting heart disease.
The risk of cardiac hospitalization (CH) in Hodgkin lymphoma (HL) patients with preexisting heart disease was evaluated. Patients with HL were identified from a population-based registry (N = 3964). Data were abstracted from records of a randomly selected subcohort (N = 1096). A population-based registry was used to identify CH. Factors associated with CH and the incidence of CH after HL were estimated with competing risk models. Preexisting heart disease was the strongest predictor of posttreatment CH (hazard ratio = 3.98, P < .001) and significantly modified (P = .01) the effect of treatment on the risk of CH. Among patients with preexisting heart disease, treatment with mediastinal radiation therapy plus doxorubicin-based chemotherapy was associated with a 10-year incidence of CH more than 20% higher than treatment with chemotherapy alone. There is a high risk of CH after mediastinal radiation therapy plus doxorubicin-based chemotherapy among patients with preexisting heart disease; this is an important consideration when weighing treatment options, and in the follow-up of these patients.
Myrehaug
Sten
S
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada.
Pintilie
Melania
M
Yun
Lingsong
L
Crump
Michael
M
Tsang
Richard W
RW
Meyer
Ralph M
RM
Sussman
Jonathan
J
Yu
Eric
E
Hodgson
David C
DC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects; D015331:Cohort Studies; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000209:etiology; D006689:Hodgkin Disease / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000528:radiation effects; D008875:Middle Aged; D009864:Ontario; D012042:Registries; D012307:Risk Factors; D055815:Young Adult
D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin