Long-Term Risk of Cardiac Events Requiring Interventions in Survivors of Hodgkin's Lymphoma (HL) Treated With Mediastinal Irradiation

IntroductionHodgkin’s lymphoma (HL) has become the prototype of a curable disease. However, many young survivors suffer from late adverse effects of treatment. Both chemotherapy (CT) and radiotherapy (RT) may induce primary ovarian insufficiency (POI), which has been associated with reduced bone mineral density (BMD), neurocognitive dysfunction and possibly cardiovascular disease (CVD). While the general assumption is that POI increases CVD risk, other hypotheses postulate reverse causality, suggesting that cardiovascular risk factors determine menopausal age or that biological ageing underlies both POI and CVD risk. None of these hypotheses are supported by convincing evidence. Furthermore, most studies on POI-associated conditions have been conducted in women with early natural or surgery-induced menopause with short follow-up times. In this study, we will examine the long-term effects of CT-induced and/or RT-induced POI on BMD, cardiovascular status, neurocognitive function and quality of life in female HL survivors.Methods and analysisThis study will be performed within an existing Dutch cohort of HL survivors. Eligible women were treated for HL at ages 15–39 years in three large hospitals since 1965 and survived for ≥8 years after their diagnosis. Women visiting a survivorship care outpatient clinic will be invited for a neurocognitive, cardiovascular and BMD assessment, and asked to complete several questionnaires and to provide a blood sample. Using multivariable regression analyses, we will compare the outcomes of HL survivors who developed POI with those who did not. Cardiovascular status will also be compared with women with natural POI.Ethics and disseminationThis study has been approved by the Institutional Review Board of the Netherlands Cancer Institute and has been registered at ‘Toetsingonline’ from the Dutch Central Committee on Research involving Human Subjects (file no. NL44714.031.13). Results will be disseminated through peer-reviewed publications and will be incorporated in follow-up guidelines for HL survivors.

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Bone Involvement in Hodgkin’s Lymphoma: Clinical Features and Outcome

Acta Haematologica ◽

10.1159/000490489 ◽

2018 ◽

Vol 140 (3) ◽

pp. 178-182 ◽

Cited By ~ 3

Author(s):

Francesco Gaudio ◽

Pasquale Pedote ◽

Artor Niccoli Asabella ◽

Giuseppe Ingravallo ◽

Paola Sindaco ◽

...

Keyword(s):

Hodgkin’S Lymphoma ◽

Bone Involvement ◽

Hodgkin's Lymphoma ◽

Bone Lesions ◽

Advanced Stages ◽

Primary Bone ◽

Long Term Prognosis ◽

Time Of Presentation

Hodgkin’s lymphoma (HL) is now a highly curable disease, with an improving 5-year survival rate that has now reached 86%. At the time of presentation, HL is usually almost entirely confined to the lymph nodes. We performed a retrospective single-institution study of 384 cases with a median follow-up of 44 months, with the aim of identifying clinical and radiological characteristics and outcomes of patients with bone HL; 32 patients (8%) had primary bone involvement, always with concurrent nodal disease. These included 22 men (69%) and 10 women (31%) with the median age as 41 years. Advanced stages and nodular sclerosis histology prevailed among the subgroup. Radiographic features of bone HL are not specific but indicate a destructive malignant process with osteosclerosis and/or osteolysis. With current chemotherapeutic regimens, the long-term prognosis of patients with osseous HL appears good. The presence of bone lesions in HL should not be interpreted as implying a worse prognosis than without bone involvement.

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Treatment-related sequelae in Hodgkin’s lymphoma after mediastinal irradiation

International Journal of Hematology ◽

10.1007/s12185-021-03264-x ◽

2021 ◽

Author(s):

Eric Yi-Liang Shen ◽

Din-Li Tsan ◽

Yin-yin Chiang ◽

Shinn-Yn Lin

Keyword(s):

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Mediastinal Irradiation

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Association between B Cell Growth Factors and Primary Sjögren’s Syndrome-Related Autoantibodies in Patients with Non-Hodgkin’s Lymphoma

Journal of Immunology Research ◽

10.1155/2019/7627384 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Zhenhua Xian ◽

Dehua Fu ◽

Shuang Liu ◽

Yang Yao ◽

Chun Gao

Keyword(s):

Cell Growth ◽

B Cell ◽

Hodgkin’S Lymphoma ◽

Hodgkin's Lymphoma ◽

Lymphoma Patient ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

B Cell Growth Factor ◽

Diagnostic Panel

Despite the overall success of using R-CHOP for the care for non-Hodgkin’s lymphoma patients, it is clear that the disease is quite complex and new insight is needed to further stratify the patient for a better personized treatment. In current study, based on previous studies from animal model, new panels combining well-established cytokine (BAFF) and autoantibodies (anti-SSA/Ro) with newly identified cytokine (IL14) and autoantibodies (TSA) were used to evaluate the association between B cell growth factor and Sjögren’s related autoantibodies in NHL patients. The result clearly indicates that there was a unique difference between BAFF and IL14 in association with autoantibodies. While serum BAFF was negatively associated with the presence of both traditional anti-SSA/Ro and novel TSA antibodies in GI lymphoma patient, IL14 was positively associated with the presence of both traditional anti-SSA/Ro and novel TSA antibodies in non-GI lymphoma patient. Long-term follow-ups on these patients and evaluation of their response to the R-CHOP treatment and recurrence rate will be very interesting. Our result provides a solid evidence to support using novel diagnostic panel to better stratify the NHL patients.

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