Appropriate Surveillance for Late Complications in Patients in Remission from Hodgkin Lymphoma
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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.
KeywordsHodgkin lymphoma Hodgkin disease Surveillance Late effects Complications Survivors
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.SEER Stat Fact Sheets: Hodgkin Lymphoma. Available at http://seer.cancer.gov/statfacts/html/hodg.html. Accessed March 2012.
- 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
- 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
- 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.
- 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
- 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
- 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
- 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.
- 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
- 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