Clinically significant cardiac disease in patients with Hodgkin lymphoma treated with mediastinal irradiation

Author:

Galper Shira L.1,Yu James B.2,Mauch Peter M.1,Strasser Jon F.1,Silver Barbara1,LaCasce Ann3,Marcus Karen J.1,Stevenson Mary Ann4,Chen Ming Hui5,Ng Andrea K.1

Affiliation:

1. Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, and Children's Hospital, Boston, MA;

2. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT;

3. Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA;

4. Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA; and

5. Department of Cardiology, Children's Hospital Boston and Department of Medicine, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA

Abstract

Abstract This study assessed the cumulative incidence of clinically significant cardiac disease in 1279 Hodgkin lymphoma patients treated with mediastinal irradiation and quantified the standard incidence ratios (SIRs) and absolute excess risks of cardiac procedures compared with a normal matched population. Cox regression analysis was used to explore factors associated with cardiac complications. Poisson regression analysis of SIRs was used to estimate the excess risk of cardiac interventions from mediastinal irradiation. After a median follow-up of 14.7 years, 187 patients experienced 636 cardiac events and 89 patients required a cardiac procedure. 5-, 10-, 15-, and 20-year cumulative incidence rates of cardiac events were 2.2%, 4.5%, 9.6%, and 16%. SIRs for cardiac procedures were increased for coronary artery bypass graft (3.19), percutaneous intervention (1.55), implantable cardioverter defibrillator or pacemaker placement (1.9), valve surgery (9.19), and pericardial surgery (12.91). Absolute excess risks were 18.2, 19.3, 9.4, 14.1, and 4.7 per 10 000 person-years, respectively. Older age at diagnosis and male sex were predictors for cardiac events. However, younger age at diagnosis was associated with excess risk specifically from radiation therapy compared with the general population. These results may help guideline development for both the types and timing of cardiac surveillance in survivors of Hodgkin lymphoma.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference32 articles.

1. Leukemia and Lymphoma Society Hodgkin Lymphoma Facts and Statistics. Accessed October 11, 2010 http://www.leukemia-lymphoma.org/all_page.adp?item_id=8312

2. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease.;Ferme;New Engl J Med,2007

3. Hodgkin disease survival in Europe and the U.S.: prognostic significance of morphologic groups.;Allemani;Cancer,2006

4. Cardiac disease following treatment of Hodgkin's disease in children and adolescents. [see comment].;Hancock;J Clin Oncol,1993

5. Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study.;Swerdlow;J Natl Cancer Inst,2007

Cited by 206 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3