Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study

The contribution of specific cancer therapies, comorbid medical conditions, and host factors to mortality risk after pediatric Hodgkin lymphoma (HL) is unclear. We assessed leading morbidities, overall and cause-specific mortality, and mortality risks among 2742 survivors of HL in the Childhood Canc...

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Vydáno v:Blood Ročník 117; číslo 6; s. 1806
Hlavní autoři: Castellino, Sharon M, Geiger, Ann M, Mertens, Ann C, Leisenring, Wendy M, Tooze, Janet A, Goodman, Pam, Stovall, Marilyn, Robison, Leslie L, Hudson, Melissa M
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 10.02.2011
Témata:
Adolescent
Adult
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Cardiovascular Diseases - mortality
Child
Child, Preschool
Cohort Studies
Comorbidity
Female
Hodgkin Disease - complications
Hodgkin Disease - epidemiology
Hodgkin Disease - mortality
Humans
Male
Morbidity
Neoplasms, Second Primary - epidemiology
Neoplasms, Second Primary - mortality
Retrospective Studies
Risk Factors
Survivors - statistics & numerical data
United States - epidemiology
Young Adult
United States
ISSN:1528-0020, 1528-0020
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Shrnutí:The contribution of specific cancer therapies, comorbid medical conditions, and host factors to mortality risk after pediatric Hodgkin lymphoma (HL) is unclear. We assessed leading morbidities, overall and cause-specific mortality, and mortality risks among 2742 survivors of HL in the Childhood Cancer Survivor Study, a multi-institutional retrospective cohort study of survivors diagnosed from 1970 to 1986. Excess absolute risk for leading causes of death and cumulative incidence and standardized incidence ratios of key medical morbidities were calculated. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of risks for overall and cause-specific mortality. Substantial excess absolute risk of mortality per 10,000 person-years was identified: overall 95.5; death due to HL 38.3, second malignant neoplasms 23.9, and cardiovascular disease 13.1. Risks for overall mortality included radiation dose ≥ 3000 rad ( ≥ 30 Gy; supra-diaphragm: HR, 3.8; 95% CI, 1.1-12.6; infradiaphragm + supradiaphragm: HR, 7.8; 95% CI, 2.4-25.1), exposure to anthracycline (HR, 2.6; 95% CI, 1.6-4.3) or alkylating agents (HR, 1.7; 95% CI, 1.2-2.5), non-breast second malignant neoplasm (HR, 2.6; 95% CI 1.4-5.1), or a serious cardiovascular condition (HR, 4.4; 95% CI 2.7-7.3). Excess mortality from second neoplasms and cardiovascular disease vary by sex and persist > 20 years of follow-up in childhood HL survivors.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1528-0020
1528-0020
DOI:10.1182/blood-2010-04-278796