Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood Journal Article

Authors: Matasar, M. J.; Ford, J. S.; Riedel, E. R.; Salz, T.; Oeffinger, K. C.; Straus, D. J.
Article Title: Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood
Abstract: Background: Survivors of Hodgkin's lymphoma (HL) treated as adults are at risk for late effects of therapy. However, the burden of late morbidity and mortality among adults treated for HL remains incompletely characterized. Methods: Vital status and, for deceased, cause of death were determined for 746 adults treated on a first-line trial at a single center from 1975 to 2000. Survivors completed a detailed survey describing their physical and mental health. A severity score (grades 1-4, ranging from mild to life-threatening or disabling) was assigned to self-reported conditions. Results: At a median follow-up of 22 years, 227 of patients (30.4%) had died, 107 (47.1%) from HL, 120 (52.9%) from other causes, including second primary malignancies (SPMs) (n = 52) and cardiovascular disease (n = 27). Across the duration of follow-up, all-cause and SPM-specific risk of death remained higher than predicted by normative data. Among survivors, late morbidity survey data are available for 238 patients (45.9%). Ninety-four-point-one percent of respondents reported at least one morbidity, and 47.5% reported at least one grade 3 or 4 morbidity; 20.2% reported two or more grade 3 morbidities. Commonly reported morbidities included cardiovascular (54.6%), endocrine (68.5%), pulmonary disease (21.4%), and nonfatal second malignancy (23.1%). Anxiety, depression, and fear of recurrence were frequently reported. Conclusions: Among a large cohort of patients treated for HL with extensive follow-up, risk of late mortality from causes other than HL and prevalence of late medical morbidity are high. Guidelines for prevention, screening, and management of late effects in adult survivors of HL are needed. © 2015 The Author. Published by Oxford University Press. All rights reserved.
Journal Title: JNCI: Journal of the National Cancer Institute
Volume: 107
Issue: 4
ISSN: 0027-8874
Publisher: Oxford University Press  
Date Published: 2015-04-01
Start Page: djv018
Language: English
DOI: 10.1093/jnci/djv018
PROVIDER: scopus
PUBMED: 25717170
Notes: Export Date: 2 July 2015 -- Source: Scopus
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MSK Authors
  1. Talya Salz
    31 Salz
  2. Jennifer S Ford
    57 Ford
  3. Kevin Oeffinger
    255 Oeffinger
  4. Matthew J Matasar
    122 Matasar
  5. David J Straus
    213 Straus