Castellino SM. Blood.
Survivors of pediatric Hodgkins lymphoma are at
increased mortality risk more than 20 years after diagnosis, primarily due to
excess mortality from second neoplasms and cardiovascular disease, a study
Because of this excess risk, survivors of pediatric
Hodgkins lymphoma and their physicians later in life should be aware of
these specific health risks, the researchers wrote.
Data were gathered on the leading mortalities, overall
and cause-specific mortality and mortality risks in 2,742 pediatric
Hodgkins lymphoma survivors who were enrolled in the Childhood Cancer
Survivor Study. Patients were diagnosed between 1970 and 1986.
Researchers calculated an excess absolute risk for death
and the incidence of key medical morbidities.
They found that these survivors had a substantial excess
absolute risk for mortality, at a rate of 95.5 per 10,000 person-years. Of the
2,633 members of the cohort, 500 deaths were observed. The most prevalent
causes of death were Hodgkins lymphoma (35%), second malignant neoplasm
(23%) and cerebrovascular and heart disease (14%).
Thirty years post-diagnosis OS was 74.1% (95% CI,
71.8%-76.6%) and was different by sex (P=.007). Risk for second
malignant neoplasm also differed by sex (P<.001), at 6.3 (95% CI,
5.6-7.1) for men and 12.0 for women (95% CI, 10.4-13.8).
Finally, the researchers identified risks that increased
overall mortality among these survivors. These risks included a radiation dose
greater than 30 Gy, exposure to anthracycline or alkylating agents, non-breast
second malignant neoplasm or a serious cardiovascular condition.