Long-term cause-specific mortality in adolescent and young adult Hodgkin lymphoma patients treated with contemporary regimens-A nationwide Danish cohort study.

Autor: Rossetti S; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Juul SJ; Department of Clinical Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Eriksson F; Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark., Warming PE; Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Glinge C; Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., El-Galaly TC; Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.; Department of Hematology, Odense University Hospital, Odense, Denmark.; Department of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden., Haaber Christensen J; Department of Hematology, Odense University Hospital, Odense, Denmark., Kamper P; Department of Hematology, University Hospital of Aarhus, Aarhus, Denmark., de Nully Brown P; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Gislason GH; Department of Cardiology, Herlev and Gentofte Hospital, Herlev, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Vestmø Maraldo M; Department of Clinical Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Tfelt-Hansen J; Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Forensic Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Hutchings M; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Oct; Vol. 205 (4), pp. 1374-1382. Date of Electronic Publication: 2024 Jun 12.
DOI: 10.1111/bjh.19586
Abstrakt: The documented treatment-induced excess mortality in Hodgkin lymphoma (HL) has spurred important treatment changes over recent decades. This study aimed to examine mortality among young HL patients treated with contemporary strategies, including historical data comparison. This nationwide study included 1348 HL patients, diagnosed in 1995-2015 and aged 15-40 at diagnosis. Among the patients, 66.5% had Ann Arbor stage I-II and 33.5% had stage III-IV disease. With a median follow-up of 14.76 years, 139 deaths occurred, yielding a 5-year overall survival of 94.6%. Older age, advanced disease, earlier treatment periods and extensive regimens were associated with higher overall mortality risk. The cumulative risk of HL-related death showed an initial sharp rise, with a plateau at 5.3% 10-year post-diagnosis. Deaths due to cardiovascular or pulmonary diseases and second cancers initially had minimal risk, gradually reaching 1.2% and 2.0% at the 20-year mark respectively. HL cases had a 7.5-fold higher mortality hazard than the background population. This study suggests that contemporary HL treatment still poses excess mortality risk, but recent changes have notably reduced overall and cause-specific mortality compared to earlier eras. Balancing treatment efficacy and toxicity remains crucial, but our findings highlight improved outcomes with modern treatment approaches.
(© 2024 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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