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Blood, 1 March 2007, Vol. 109, No. 5, pp. 1878-1886. Prepublished online as a Blood First Edition Paper on November 21, 2006; DOI 10.1182/blood-2006-07-034405. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-07-034405v1 109/5/1878    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Aleman, B. M. P. Articles by van Leeuwen, F. E. Search for Related Content PubMed PubMed Citation Articles by Aleman, B. M. P. Articles by van Leeuwen, F. E. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Late cardiotoxicity after treatment for Hodgkin lymphoma Berthe M. P. Aleman1, Alexandra W. van den Belt-Dusebout2, Marie L. De Bruin2, Mars B. van 't Veer3, Margreet H. A. Baaijens4, Jan Paul de Boer5, Augustinus A. M. Hart1, Willem J. Klokman2, Marianne A. Kuenen2, Gabey M. Ouwens2, Harry Bartelink1, and Flora E. van Leeuwen2 1 Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands; 2 Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; 3 Department of Hematology, the Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; 4 Department of Radiotherapy, the Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands; 5 Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands We assessed cardiovascular disease (CVD) incidence in 1474 survivors of Hodgkin lymphoma (HL) younger than 41 years at treatment (1965-1995). Multivariable Cox regression and competing risk analyses were used to quantify treatment effects on CVD risk. After a median follow-up of 18.7 years, risks of myocardial infarction (MI) and congestive heart failure (CHF) were strongly increased compared with the general population (standardized incidence ratios [SIRs] = 3.6 and 4.9, respectively), resulting in 35.7 excess cases of MI and 25.6 excess cases of CHF per 10 000 patients/year. SIRs of all CVDs combined remained increased for at least 25 years and were more strongly elevated in younger patients. Mediastinal radiotherapy significantly increased the risks of MI, angina pectoris, CHF, and valvular disorders (2- to 7-fold). Anthracyclines significantly added to the elevated risks of CHF and valvular disorders from mediastinal RT (hazard ratios [HRs] were 2.81 and 2.10, respectively). The 25-year cumulative incidence of CHF after mediastinal radiotherapy and anthracyclines in competing risk analyses was 7.9%. In conclusion, risks of several CVDs are 3- to 5-fold increased in survivors of HL compared with the general population, even after prolonged follow-up, leading to increasing absolute excess risks over time. Anthracyclines further increase the elevated risks of CHF and valvular disorders from mediastinal radiotherapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. Rademaker, H. Schoder, N. S. Ariaratnam, H. W. Strauss, J. Yahalom, R. Steingart, and K. C. Oeffinger Coronary Artery Disease After Radiation Therapy for Hodgkin's Lymphoma: Coronary CT Angiography Findings and Calcium Scores in Nine Asymptomatic Patients Am. J. Roentgenol., July 1, 2008; 191(1): 32 - 37. [Abstract] [Full Text] [PDF] A. K. Ng, S. Li, D. Neuberg, R. Chi, D. C. Fisher, B. Silver, and P. M. Mauch A prospective study of pulmonary function in Hodgkin's lymphoma patients Ann. Onc., May 7, 2008; (2008) mdn284v1. [Abstract] [Full Text] [PDF] M. L. De Bruin, J. Huisbrink, M. Hauptmann, M. A. Kuenen, G. M. Ouwens, M. B. van't Veer, B. M. P. Aleman, and F. E. van Leeuwen Treatment-related risk factors for premature menopause following Hodgkin lymphoma Blood, January 1, 2008; 111(1): 101 - 108. [Abstract] [Full Text] [PDF] Cardiotoxicity After Treatment for Hodgkin Lymphoma Journal Watch Oncology and Hematology, March 19, 2007; 2007(319): 2 - 2. [Full Text]

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