Risk of Cardiovascular Disease in Patients With Classical Hodgkin Lymphoma: A Danish Nationwide Register‐Based Cohort Study
Risk of cardiovascular disease (CVD) in patients with classical Hodgkin lymphoma (cHL) undergoing contemporary treatment is unclear. cHL patients ≥ 18 years at diagnosis treated with doxorubicin-containing chemotherapy between 2000 and 2022 were matched 1:5 with comparators on birth year, sex, and Charlson Comorbidity Index at time of matching (score of 0 or ≥ 1). Cause-specific cumulative incidence of a composite of CVDs with corresponding 95% confidence intervals (CIs) were computed with death and lymphoma relapse as competing events (i.e., by censoring individuals at such occurrences) using the Aalen-Johansen estimator. A total of 1905 patients and 9525 comparators with a median follow-up of 10 years (interquartile range, [IQR]: 5.9-17.4). Median age was 39 years (IQR: 27-56), median cumulative doxorubicin dose was 250 mg/m<sup>2</sup> (IQR: 200-300). The CVD cumulative incidences were 4.7% (95% CI: 3.6-5.7) for patients versus 2.6% (95% CI: 2.3-2.9) for comparators at 5 years, 8.9% (95% CI: 7.2-10.5) versus 5.5% (95% CI: 4.9-6.0) at 10 years, and 17.0% (95% CI: 14.1-19.9) versus 8.2% (95% CI: 7.4-9.0) at 15 years. CVD remains a substantial effect after contemporary treatment for cHL, suggesting that awareness of symptoms and a low threshold for referral to diagnostic examination are still important measures during survivorship.
Authors
- Joachim Bæch (ORCID: https://orcid.org/0000-0001-8848-4879)
- Rasmus Bo Dahl‐Sørensen (ORCID: https://orcid.org/0000-0002-3439-316X)
- Signe Riddersholm
- Lars Køber (ORCID: https://orcid.org/0000-0002-6635-1466)
- Mikkel Porsborg Andersen (ORCID: https://orcid.org/0000-0001-6162-5205)
- Nour R. Al‐Hussainy (ORCID: https://orcid.org/0000-0002-9118-206X)
- Tarec Christoffer El‐Galaly (ORCID: https://orcid.org/0000-0002-4406-380X)
- Peter Søgaard (ORCID: https://orcid.org/0000-0002-7441-0630)
- Martin Hutchings (ORCID: https://orcid.org/0000-0003-3873-1741)
- Peter Kamper (ORCID: https://orcid.org/0000-0002-4148-1969)
- Kristian Hay Kragholm (ORCID: https://orcid.org/0000-0001-9629-8670)
- Caroline E. Dietrich (ORCID: https://orcid.org/0000-0001-8231-8183)
- Christian Tobias Torp-Pedersen (ORCID: https://orcid.org/0000-0003-2892-6131)
- Sissel J Godtfredsen (ORCID: https://orcid.org/0000-0002-1049-9285)
- Jacob Haaber Christensen
- Morten Schou
- Harman Yonis (ORCID: https://orcid.org/0000-0003-1711-7726)
Institutions
- University of Copenhagen (DK)
- Region Zealand (DK)
- Aalborg University Hospital (DK)
- Odense University Hospital (DK)
- Aarhus University Hospital (DK)
- Copenhagen University Hospital (DK)
- Gentofte Hospital (DK)
- Rigshospitalet (DK)
- Karolinska Institutet (SE)
- Zealand University Hospital (DK)
- Nordsjællands Hospital (DK)
- Aalborg University (DK)
Publication Details
- Journal
- European Journal Of Haematology
- Published
- 2024-11-06
- DOI
- https://doi.org/10.1111/ejh.14334
- Citations
- 3
- Primary Topic
- Chemotherapy-induced cardiotoxicity and mitigation
- Type
- article
- Field-Weighted Citation Impact
- 1.21
Funders
- Aalborg Universitet
- Novo Nordisk
- Aalborg Universitetshospital
- TrygFonden