scholarly journals Rationale and design of a cohort study on primary ovarian insufficiency in female survivors of Hodgkin’s lymphoma: influence on long-term adverse effects (SOPHIA)

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e018120
Author(s):  
Inge M Krul ◽  
Annemieke W J Opstal-van Winden ◽  
Josée M Zijlstra ◽  
Yolande Appelman ◽  
Sanne B Schagen ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Hodgkin’S Lymphoma ◽  
Primary Ovarian Insufficiency ◽  
Hodgkin's Lymphoma ◽  
Reverse Causality ◽  
Mineral Density ◽  
Cvd Risk ◽  
Ovarian Insufficiency

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.

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

2018 ◽  
Vol 140 (3) ◽  
pp. 178-182 ◽  
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.

Long-Term Complications of Lymphoma and Its Treatment

2011 ◽  
Vol 29 (14) ◽  
pp. 1885-1892 ◽  
Author(s):  
Andrea K. Ng ◽  
Ann LaCasce ◽  
Lois B. Travis
Keyword(s):  
Late Effects ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Large Body ◽  
Hodgkin's Lymphoma ◽  
Long Term Effects ◽  
Early Stage Disease ◽  
Long Term Follow Up

As a result of therapeutic advances, there is a growing population of survivors of both Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). A thorough understanding of the late effects of cancer and its treatment, including the risk of developing a second malignancy and non-neoplastic complications, most notably cardiac disease, is essential for the proper long-term follow-up care of these patients. For HL survivors cured in the past 5 decades, a large body of literature describes a range of long-term effects, many of which are related to extent of treatment. These studies form the basis for many of the follow-up recommendations developed for HL survivors. As HL therapy continues to evolve, however, with an emphasis toward treatment reduction, in particular for early-stage disease, it will be important to rigorously observe this new generation of patients long term to document and quantify late effects associated with modern treatments. Although data on late effects after NHL therapy have recently emerged, the formulation of structured follow-up plans for this heterogeneous group of survivors is challenging, given the highly variable natural history, treatments, and overall prognosis. However, the chemotherapy and radiation therapy approaches for some types of NHL are similar to that for HL; thus, some of the follow-up guidelines for patients with HL may also be transferrable to selected survivors of NHL. Additional work focused on treatment-related complications after NHL will facilitate the development of follow-up programs, as well as treatment refinements to minimize late effects in patients with various types of NHL.

What is the Price of survival in Hodgkin's lymphoma? Long-term follow-up of cured patients

2007 ◽  
Vol 25 (4) ◽  
pp. 178-183 ◽  
Author(s):  
Miltényi Zsófia ◽  
Keresztes Katalin ◽  
Végh Judit ◽  
Székely György ◽  
Illés Árpád
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Long Term Follow Up

Hodgkin’s Lymphoma in Adolescents and Young Adults

2012 ◽  
Vol 08 (02) ◽  
pp. 116 ◽  
Author(s):  
Laura Rodriguez ◽  
Angela Punnett ◽  
◽  
Keyword(s):  
Young Adults ◽  
Hodgkin’S Lymphoma ◽  
Collaborative Study ◽  
Study Groups ◽  
Primary Treatment ◽  
Adolescents And Young Adults ◽  
Adolescent And Young Adult ◽  
Hodgkin's Lymphoma

Adolescents and young adults (AYAs) are defined as those individuals between the ages of 15 and 39 years. Hodgkin’s lymphoma (HL) is the most common cancer observed in AYAs. Over the last two decades, significant improvements in both survival from HL and the reduction of therapy-related late effects have resulted from the work of collaborative study groups in pediatric and adult domains. The adolescent and young adult (AYA) population falls between these domains. AYA patients are in a critical developmental transition, with significant psychosocial challenges that may impact on the outcome of the primary treatment as well as on the medical care and surveillance of long-term sequelae in survivors. This article will examine available literature regarding outcomes for HL in the AYA population, identifying issues unique to this group, therapeutic options, and specific concerns in follow-up.

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