Current Hematologic Malignancy Reports

, Volume 7, Issue 3, pp 200–207

Appropriate Surveillance for Late Complications in Patients in Remission from Hodgkin Lymphoma

Lymphomas (J Armitage and P McLaughlin, Section Editors)
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Abstract

Once considered to be incurable, now most patients with the diagnosis of Hodgkin lymphoma (HL) survive and are cured of their disease. Although HL survivors are out living their disease, they continue to have increased morbidity and mortality compared to their age-matched and sex-matched peers in the general population. Late complications of their treatment are well documented and include cardiovascular diseases, pulmonary diseases, endocrine dysfunction and second malignancy. Research exploring appropriate surveillance for these complications is lacking. However, evidence to support surveillance is mounting and many are publishing consensus-based guidelines recommending surveillance for these anticipated complications. This review will summarize the most recent literature addressing the appropriate surveillance for late complications in patients in remission from HL.

Keywords

Hodgkin lymphoma Hodgkin disease Surveillance Late effects Complications Survivors 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    SEER Stat Fact Sheets: Hodgkin Lymphoma. Available at http://seer.cancer.gov/statfacts/html/hodg.html. Accessed March 2012.
  2. 2.
    Aleman B, van den Belt-Dusebout A, Klokman WJ, et al. Long-term cause-specific mortality of patients treated for Hodgkin’s disease. J Clin Oncol. 2003;21:3431–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Hodgson DC. Late effects in the era of modern therapy for Hodgkin lymphoma. Hematology Am Soc Hematol Educ Program. 2011:323–329.Google Scholar
  4. 4.
    Travis LB, Hill D, Dores GM, et al. Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma. J Natl Cancer Inst. 2005;97:1428–37.PubMedCrossRefGoogle Scholar
  5. 5.
    Milano MT, Li H, Gail MH, et al. Long-term survival among patients with Hodgkin’s lymphoma who developed breast cancer: a population-based study. J Clin Oncol. 2010;28:5088–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Dores GM, Anderson WF, Beane Freeman LE, et al. Risk of breast cancer according to clinicopathologic features among long-term survivors of Hodgkin’s lymphoma treated with radiotherapy. Br J Cancer. 2010;103:1081–4.PubMedCrossRefGoogle Scholar
  7. 7.
    • Elkin EB, Klem ML, Gonzales AM, et al. Characteristics and outcomes of breast cancer in women with and without a history of radiation for Hodgkin’s lymphoma: a multi-institutional, matched cohort study. J Clin Oncol. 2011;29:2466–2473. Breast cancer after radiotherapy for HL was more likely to be detected by screening and more likely to be diagnosed at an earlier stage and to be bilateral at time of diagnosis. PubMedCrossRefGoogle Scholar
  8. 8.
    Hodgson DC, Grunfeld E, Gunraj N, et al. A population-based study of follow-up care for Hodgkin lymphoma survivors. Cancer. 2010;116:3417–25.PubMedCrossRefGoogle Scholar
  9. 9.
    Howell SJ, Searle C, Goode V, et al. The UK national breast cancer screening programme for survivors of Hodgkin lymphoma detects breast cancer at an early stage. Br J Cancer. 2009;101:582–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Oeffinger KC, Hudson MM, Mertens AC, et al. Increasing rates of breast cancer and cardiac surveillance among high-risk survivors of childhood Hodgkin lymphoma following a mailed, one-age survivorship care plan. Pediatr Blood Canc. 2010;56:818–24.CrossRefGoogle Scholar
  11. 11.
    Travis LB, Gospodarowicz M, Curtis RE, et al. Lung cancer following chemotherapy and radiotherapy for Hodgkin’s disease. J Natl Cancer Inst. 2002;94:182–92.PubMedCrossRefGoogle Scholar
  12. 12.
    Schoenfeld JD, Mauch PM, Das P, et al. Lung malignancies after Hodgkin lymphoma: disease characteristics, detection methods and clinical outcome. Ann Oncol. 2011. doi:10.1093/annonc/mdr551.
  13. 13.
    Milano MT, Li H, Constine LS, et al. Variables affecting survival after second primary lung cancer: a population-based study of 187 Hodgkin’s lymphoma patients. J Thorac Dis. 2012;4:22–9.PubMedGoogle Scholar
  14. 14.
    The International Early Lung Cancer Action Program Investigators. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med. 2006;355:1763–71.CrossRefGoogle Scholar
  15. 15.
    Menezes RJ, Roberts HC, Paul NS, et al. Lung cancer screening using low-dose computed tomography in at-risk individuals: the Toronto experience. Lung Cancer. 2010;67:177–83.PubMedCrossRefGoogle Scholar
  16. 16.
    Lee AI, Zuckerman DS, Van den Abbeele AD, et al. Surveillance imaging of Hodgkin lymphoma patients in first remission. Cancer. 2010;116:3835–42.PubMedCrossRefGoogle Scholar
  17. 17.
    Ng A, LaCasce A, Travis L. Long-term complications of lymphoma and its treatment. J Clin Oncol. 2011;29:1885–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Hudson M, Mulrooney D, Bowers D, et al. High-risk populations identified in Childhood Cancer Survivor Study investigations: implications for risk-based surveillance. J Clin Oncol. 2009;27:2405–14.PubMedCrossRefGoogle Scholar
  19. 19.
    Andersson A, Naslund U, Tavelin B, et al. Long-term risk of cardiovascular disease in Hodgkin lymphoma survivors-retrospective cohort analyses and a concept for prospective intervention. Int J Cancer. 2009;124:1914–7.PubMedCrossRefGoogle Scholar
  20. 20.
    • Galper SL, Yu JB, Mauch PM, et al. Clinically significant cardiac disease in patients with Hodgkin lymphoma treated with mediastinal irradiation. Blood. 2011;117:412–418. Cumulative incidence rates of clinically significant cardiac disease in HL patients over time and older age at diagnosis and male sex were predictors for undergoing cardiac procedure. Younger age at diagnosis and receiving radiotherapy was also associated with increased risk for cardiac disease requiring surgical intervention. PubMedCrossRefGoogle Scholar
  21. 21.
    Myrehaug S, Pintilie M, Yun L, et al. A population-based study of cardiac morbidity among Hodgkin lymphoma patients with preexisting heart disease. Blood. 2010;116:2237–40.PubMedCrossRefGoogle Scholar
  22. 22.
    Wethal T, Lund M-B, Edvardsen T, et al. Valvular dysfunction and left ventricular changes in Hodgkin’s lymphoma survivors. A longitudinal study. Br J Cancer. 2009;101:575–81.PubMedCrossRefGoogle Scholar
  23. 23.
    Tsai H-R, Gjesdal O, Wethal T, et al. Left ventricular function assessed by two-dimensional speckle tracking echocardiography in long-term survivors of Hodgkin’s lymphoma treated by mediastinal radiotherapy with or without anthracycline therapy. Am J Cardiol. 2011;107:472–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Alehan D, Sahin M, Varan A, et al. Tissue doppler evaluation of systolic and diastolic cardiac functions in long-term survivors of Hodgkin lymphoma. Pediatr Blood Canc. 2012;58:250–5.CrossRefGoogle Scholar
  25. 25.
    Machann W, Beer M, Breunig M, et al. Cardiac magnetic resonance imaging findings in 20-year survivors of mediastinal radiotherapy for Hodgkin’s disease. Int J Radiat Oncol Biol Phys. 2011;79:1117–23.PubMedCrossRefGoogle Scholar
  26. 26.
    Kupeli S, Hazirolan T, Varan A, et al. Evaluation of coronary artery disease by computed tomography angiography in patients treated for childhood Hodgkin’s lymphoma. J Clin Oncol. 2010;28:1025–30.PubMedCrossRefGoogle Scholar
  27. 27.
    Andersen R, Wethal T, Gunther A, et al. Relation of coronary artery calcium score to premature coronary artery disease in survivors >15 years of Hodgkin’s lymphoma. Am J Cardiol. 2010;105:149–52.PubMedCrossRefGoogle Scholar
  28. 28.
    van Leeuwen-Segarceanu EM, Bos W-J, Dorresteijn L, et al. Screening Hodgkin lymphoma survivors for radiotherapy induced cardiovascular disease. Canc Treat Rev. 2011;37:391–401.CrossRefGoogle Scholar
  29. 29.
    Conti CR, Bavry AA, Petersen JW. Silent ischemia clinical relevance. J Am Coll Cardiol. 2012;59:435–41.PubMedCrossRefGoogle Scholar
  30. 30.
    2009 Writing Group on behalf of the 2005 Heart Failure Writing Committee: 2009 Focused Update: ACCF/AHA Guidelines for the diagnosis and management of heart failure in adults. Circulation. 2009;119:1977–2016.Google Scholar
  31. 31.
    Chen AB, Punglia RS, Kuntz KM, et al. Cost effectiveness and screening interval of lipid screening in Hodgkin’s lymphoma survivors. J Clin Oncol. 2009;27:5383–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Hancock SL, Cox RS, McDougall IR. Thyroid diseases after treatment of Hodgkin’s disease. N Engl J Med. 1991;325:599–605.PubMedCrossRefGoogle Scholar
  33. 33.
    Bhatia S, Ramsay NK, Bantle JP, et al. Thyroid abnormalities after therapy for Hodgkin’s disease in childhood. Oncologist. 1996;1:62–7.PubMedGoogle Scholar
  34. 34.
    Hodgson DC. Hodgkin lymphoma: the follow-up of long-term survivors. Hematol Oncol Clin North Am. 2008;22:233–44.PubMedCrossRefGoogle Scholar
  35. 35.
    Majhail NS, Ness KK, Burns LJ, et al. Late effects in survivors of Hodgkin and non-Hodgkin lymphoma treated with autologous hematopoietic cell transplantation: a report from the bone marrow transplant survivor study. Biol Blood Marrow Transplant. 2007;13:1153–9.PubMedCrossRefGoogle Scholar
  36. 36.
    U.S. Preventive Services Task Force: Screening for osteoporosis: clinical summary of U.S. preventive services task force recommendation. AHRQ Publication No. 10-05145-EF-3, January 2011. Available at http://www.uspreventiveservicestaskorce.org/uspstf10/osteoporosis/osteosum.htm. Accessed March 2012.
  37. 37.
    De Bruin ML, Dorresteijn LD, van’t Veer MB, et al. Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma. J Natl Cancer Inst. 2009;101:928–37.PubMedCrossRefGoogle Scholar
  38. 38.
    Carver JR, Shapiro CL, Ng A, et al. American society of clinical oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol. 2007;25:3991–4008.PubMedCrossRefGoogle Scholar
  39. 39.
    • Drake MT, Maurer MJ, Link BK, et al. Vitamin D insufficiency and prognosis in non-Hodgkin’s lymphoma. J Clin Oncol. 2010;28:4191–4198. 25(OH) vitamin D insufficiency was associated with inferior event-free and overall survival in patients with diffuse large B-cell and T-cell lymphoma. PubMedCrossRefGoogle Scholar
  40. 40.
    Armitage JO. Early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363:653–62.PubMedCrossRefGoogle Scholar
  41. 41.
    Hoppe R, Advani R, Ai W, et al. Hodgkin lymphoma. JNCCN. 2011;9:1020–58.PubMedGoogle Scholar
  42. 42.
    Ng A, Constine L, Advani R, et al. ACR appropriateness criteria follow-up of Hodgkin’s Lymphoma. Reston: American College of Radiology; 2010. on-line publication.Google Scholar
  43. 43.
    Saslow D, Boetes C, Burke W, et al. American Cancer Society Guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.PubMedCrossRefGoogle Scholar
  44. 44.
    Canellos G, Niedzwiecki D, Johnson J. Long-term follow-up of survival in Hodgkin’s lymphoma. N Engl J Med. 2009;24:2390–1.CrossRefGoogle Scholar
  45. 45.
    De Bruin M, Sparidans J, van’t Veer M, et al. Breast cancer risk in female survivors of Hodgkin’s lymphoma: lower risk after smaller radiation volumes. J Clin Oncol. 2009;27:4239–46.PubMedCrossRefGoogle Scholar
  46. 46.
    Ng A, Bernardo P, Weller E, et al. Second malignancy after Hodgkin disease treated with radiation therapy or without chemotherapy: long-term risk and risk factors. Blood. 2002;100:1989–96.PubMedCrossRefGoogle Scholar
  47. 47.
    Hodgson D, Gilbert E, Dores G, et al. Long-term solid cancer risk among 5-year survivors of Hodgkin’s Lymphoma. J Clin Oncol. 2007;25:1489–97.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of OncologyUniversity of Nebraska Medical CenterOmahaUSA

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