How Hodgkin Lymphoma and Heart Disease Might Be Linked

Hodgkin lymphoma survivors may face increased heart disease risk

(RxWiki News) Hodgkin lymphoma survivors may face other health risks later on.

People who fought and survived this cancer, which starts in white blood cells, may find themselves fighting a new battle with heart disease decades later, a new study found.

“Throughout their lives, Hodgkin lymphoma survivors treated at adolescence or adulthood are at high risk for various cardiovascular diseases,” wrote the authors of this study, led by Flora E. van Leeuwen, PhD, of the Netherlands Cancer Institute in Amsterdam. “Physicians and patients should be aware of this persistently increased risk.”

More than 80 percent of people who have Hodgkin lymphoma are alive 10 years after diagnosis, Dr. van Leeuwen and team noted. But the radiation and cancer drugs used to treat this condition may increase the risk for heart damage up to 35 years later.

“In years past, cancer specialists did not know the importance of shielding the heart from radiation,” explained Sarah Samaan, MD, a board-certified cardiologist and physician partner at the Baylor Heart Hospital in Plano, TX, in an interview with dailyRx News. “This often resulted in severe coronary artery and heart valve disease decades later.”

For their study, Dr. van Leeuwen and team looked at 2,524 Dutch survivors of Hodgkin lymphoma who were younger than 51 when diagnosed with the disease, and who had been treated between the start of 1965 and the end of 1995. These researchers followed the patients for five to 47 years to see who developed heart disease.

Dr. van Leeuwen and colleagues noted 1,713 heart events in 797 total patients.

The most common type of heart disease the former Hodgkin lymphoma patients had was coronary heart disease (CHD), which is caused by a buildup of plaque in the arteries leading to the heart. Valvular heart disease (VHD) was behind the second most heart events. VHD is damage or a problem in one of the four heart valves. The third most common heart event was heart failure, which is when the heart doesn’t pump blood as well as it should.

Former Hodgkin lymphoma patients were 3.2 to 6.8 times more likely to develop these heart issues than people in the general population, Dr. van Leeuwen and team found.

These researchers said they believe the treatment these patients received for their Hodgkin lymphoma led to their heart issues later in life. More than 81 percent of the Hodgkin lymphoma survivors had received radiation to the area between the lungs.

Patients younger than 25 at the time of treatment were those most at risk for heart issues later in life.

In an editorial about this study, Emily Tonorezos, MD, of Weill Cornell Medical College in New York, and Linda Overholser, MD, of the University of Colorado Denver School of Medicine, wrote that this study may lead to more former Hodgkin lymphoma patients being identified as high-risk for heart problems and followed to ensure they stay healthy.

“This work can specifically help physicians identify their highest-risk patients: those with a history of Hodgkin lymphoma who were treated at a younger age and those who are the longest from treatment," Drs. Tonorezos and Overholser wrote.

The editorial authors said doctors should ask patients who have had Hodgkin lymphoma questions like how old they were when they were treated and what kind of treatment they received.

“If you are a Hodgkin's survivor, it's important to discuss this with your primary physician,” Dr. Samaan said. “No matter how healthy you may be now, any symptoms of chest pain or unusual shortness of breath should prompt a visit to your doctor.”

The study and editorial were published April 27 in JAMA Internal Medicine.

A grant from the Dutch Cancer Society funded this study. The editorial was funded by several grants, including one from the National Institutes of Health. The study and editorial authors disclosed no conflicts of interest.

Review Date: 
April 26, 2015