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Patients treated for Hodgkin’s lymphoma are at an increased risk of death from a heart attack for 25 years following therapy. In order to reduce the risk of death from cardiac complications, individuals diagnosed with Hodgkin’s lymphoma may wish to discuss monitoring procedures for the early detection and treatment of heart conditions.

Hodgkin’s lymphoma is a type of cancer that originates in immune cells. It is estimated that 7,350 individuals are diagnosed with Hodgkin’s lymphoma annually in the United States. Standard treatment for Hodgkin’s lymphoma often includes chemotherapy with or without radiation therapy. Patients with Hodgkin’s lymphoma whose cancer is found in the lymph nodes in the chest may receive radiation to the chest.  In addition, patients with Hodgkin’s lymphoma often receive treatment with chemotherapy. Some chemotherapy combinations may include agents referred to as anthracyclines.

Patients treated for Hodgkin’s lymphoma, particularly at less advanced stages, have excellent long-term survival and cure rates. Due to the longevity of the majority of these patients, researchers have focused on long-term quality of life issues as well as side effects that may occur long after treatment has been completed. Results from earlier studies have indicated a potential increase in the risk of heart conditions among patients with various types of cancers who receive radiation that may include the heart. As well, it is known that anthracyclines carry an increased risk of long-term damage to the heart.

Researchers from England recently conducted a clinical study to further evaluate the potential risk of heart attacks in patients with Hodgkin’s lymphoma. This study included 7,033 patients who were treated for Hodgkin’s lymphoma between 1967 and 2000. Their risk of heart attack was compared to that of the general public.

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  • Patients with Hodgkin’s lymphoma had a significantly higher rate of deaths caused by heart attacks than the general population. This risk persisted for up to 25 years following initial therapy.
  • Risk of death from heart attack was significantly increased among patients who were diagnosed and treated before age 65.
  • The risk of death from heart attack was significantly increased for patients treated with radiation to the chest and who received treatment with anthracyclines, the chemotherapy agent vincristine, or the chemotherapy regimen consisting of doxorubicin, bleomycin, vinblastine, and dacarbazine.

The researchers concluded that patients with Hodgkin’s lymphoma are at an increased risk of death from heart attack for 25 years following initial therapy, particularly among patients treated before the age of 65. Because early detection and intervention for cardiac complications can improve outcomes, patients diagnosed with Hodgkin’s lymphoma—particularly those at a higher risk of developing heart complications—may wish to speak with their physician regarding their individual risk of heart attack and possible monitoring for cardiac conditions.

Reference: Swerdlow A, Higgins C, Smith P, et al. Myocardial infarction mortality risk after treatment for Hodgkin disease: a collaborative British cohort study. Journal of the National Cancer Institute. 2007; 99:206-214.