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Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood.

Publication ,  Journal Article
Matasar, MJ; Ford, JS; Riedel, ER; Salz, T; Oeffinger, KC; Straus, DJ
Published in: J Natl Cancer Inst
April 2015

BACKGROUND: Survivors of Hodgkin's lymphoma (HL) treated as adults are at risk for late effects of therapy. However, the burden of late morbidity and mortality among adults treated for HL remains incompletely characterized. METHODS: Vital status and, for deceased, cause of death were determined for 746 adults treated on a first-line trial at a single center from 1975 to 2000. Survivors completed a detailed survey describing their physical and mental health. A severity score (grades 1-4, ranging from mild to life-threatening or disabling) was assigned to self-reported conditions. RESULTS: At a median follow-up of 22 years, 227 of patients (30.4%) had died, 107 (47.1%) from HL, 120 (52.9%) from other causes, including second primary malignancies (SPMs) (n = 52) and cardiovascular disease (n = 27). Across the duration of follow-up, all-cause and SPM-specific risk of death remained higher than predicted by normative data. Among survivors, late morbidity survey data are available for 238 patients (45.9%). Ninety-four-point-one percent of respondents reported at least one morbidity, and 47.5% reported at least one grade 3 or 4 morbidity; 20.2% reported two or more grade 3 morbidities. Commonly reported morbidities included cardiovascular (54.6%), endocrine (68.5%), pulmonary disease (21.4%), and nonfatal second malignancy (23.1%). Anxiety, depression, and fear of recurrence were frequently reported. CONCLUSIONS: Among a large cohort of patients treated for HL with extensive follow-up, risk of late mortality from causes other than HL and prevalence of late medical morbidity are high. Guidelines for prevention, screening, and management of late effects in adult survivors of HL are needed.

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Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

April 2015

Volume

107

Issue

4

Location

United States

Related Subject Headings

  • Time Factors
  • Surveys and Questionnaires
  • Risk
  • Prevalence
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neoplasms, Second Primary
  • Morbidity
  • Middle Aged
  • Mental Health
 

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Matasar, M. J., Ford, J. S., Riedel, E. R., Salz, T., Oeffinger, K. C., & Straus, D. J. (2015). Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood. J Natl Cancer Inst, 107(4). https://doi.org/10.1093/jnci/djv018
Matasar, Matthew J., Jennifer S. Ford, Elyn R. Riedel, Talya Salz, Kevin C. Oeffinger, and David J. Straus. “Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood.J Natl Cancer Inst 107, no. 4 (April 2015). https://doi.org/10.1093/jnci/djv018.
Matasar MJ, Ford JS, Riedel ER, Salz T, Oeffinger KC, Straus DJ. Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood. J Natl Cancer Inst. 2015 Apr;107(4).
Matasar, Matthew J., et al. “Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood.J Natl Cancer Inst, vol. 107, no. 4, Apr. 2015. Pubmed, doi:10.1093/jnci/djv018.
Matasar MJ, Ford JS, Riedel ER, Salz T, Oeffinger KC, Straus DJ. Late morbidity and mortality in patients with Hodgkin's lymphoma treated during adulthood. J Natl Cancer Inst. 2015 Apr;107(4).
Journal cover image

Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

April 2015

Volume

107

Issue

4

Location

United States

Related Subject Headings

  • Time Factors
  • Surveys and Questionnaires
  • Risk
  • Prevalence
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neoplasms, Second Primary
  • Morbidity
  • Middle Aged
  • Mental Health