Hodgkin Lymphoma Patients Have Higher Cardiovascular Mortality Risk Than Cancer

People with early-stage Hodgkin lymphoma (HL) are at higher risk of dying from cardiovascular disease than from cancer, according to new research.

Caiwen Ou, M.D., Ph.D, with Southern Medical University in Guangzhou, China, led the research team that conducted the study, published in Cancer.

“We conducted this study because cardiovascular disease may be the most common non-malignant long-term complication and a prevalent cause for non-malignant death following treatment in HL survivors,” said senior author Caiwen Ou, M.D., Ph.D., of Southern Medical University in Guangzhou, China, in a news release.

The signficant multicenter study included 15,889 children and adults in the US who were diagnosed with classical Hodgkin lymphoma between 1983 and 2015. Most previous studies involving cardiovascular side effects of the disease focused only on children or young adults, and few studies observed patients diagnosed at all ages, Ou wrote.

Ou and colleagues found that, among patients in stage I and stage II classical Hodgkin lymphoma, the proportional death rate for cardiovascular disease (CVD) exceeded that for classical Hodgkin lymphoma. Notably, the absolute excess CVD among among patients in stage I reached 48.5.

“Patients with stage I or II disease had a higher risk of CVD death in almost all the follow-up intervals, compared with the general population. Patients in stage III were more likely to suffer from CVD mortality than the general population after approximately 120 months,” Ou wrote.

For almost all the patients with stage I or stage II disease, the cumulative incidence of CVD mortality exceeded that of classical Hodgkin lymphoma and other neoplasms over time. This trend was not influenced by the factors such as age at diagnosis, race, sex, and whether or not surgery was performed.

“This seemed to be opposite to the previous studies that have reported that the proportion of patients who died from cardiovascular disease was lower than that from either cHL (classicial Hodgkin lymphoma) or other neoplasms,” Ou wrote.

While the risk of mortality from Hodgkin disease has declined sharply in recent decades, the risk of CVD mortality among patients with classica Hodgkin disase declined slowly or even remained unchanged among some populations, the researchers wrote.

“Our results indicate that more effective measures are needed to reduce the risk of cardiovascular disease-related deaths in classic HL (Hodgkin lymphoma) survivors,” said Weijing Feng, M.D., with the Department of Cardiology at Southern Medical University in Guangzhou, China.

Some patients in advanced stages are less likely to experience CVD mortality compared with the general population, the researchers found. “Our results showed that the cumulative incidence of cHL (classical Hodgkin lymphoma) mortality among patients in stage III or IV was much higher than that among in stage I or II. Therefore, we considered that these patients were more likely to die from cHL or other diseases,” Ou wrote.