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Blood, 1 April 2006, Vol. 107, No. 7, pp. 2912-2919. Prepublished online as a Blood First Edition Paper on December 8, 2005; DOI 10.1182/blood-2005-08-3392. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-08-3392v1 107/7/2912    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 Moser, E. C. Articles by Kluin-Nelemans, H. C. Search for Related Content PubMed PubMed Citation Articles by Moser, E. C. Articles by Kluin-Nelemans, H. C. Related Collections Hemostasis, Thrombosis, and Vascular Biology Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  NEOPLASIA Long-term risk of cardiovascular disease after treatment for aggressive non-Hodgkin lymphoma Elizabeth C. Moser, Evert M. Noordijk, Flora E. van Leeuwen, Saskia le Cessie, Joke W. Baars, José Thomas, Patrice Carde, Jacobus H. Meerwaldt, Martine van Glabbeke, and Hanneke C. Kluin-Nelemans From the European Organization for Research on Treatment of Cancer (EORTC) Data Center, Brussels, Belgium; the Department of Radiotherapy, Leiden University Medical Center, The Netherlands; the Department of Epidemiology, the Netherlands Cancer Institute, Amsterdam, The Netherlands; the Department of Medical Statistics, Leiden University Medical Center, The Netherlands; the Department of Medical Oncology, Antoni van Leeuwenhoek ziekenhuis, Amsterdam, The Netherlands; the Department of Oncology, U.Z. Gasthuisberg, Leuven, Belgium; the Department of Hematology, Institute Gustave Roussy, Villejuif, France; the Department of Radiotherapy, Medical Spectrum Twente, Enschede, The Netherlands; and the Department of Hematology, University Medical Center, University of Groningen, The Netherlands. Cardiovascular disease frequently occurs after lymphoma therapy, but it is common in the general population too. Therefore, risk estimation requires comparison to population-based rates. We calculated risk by standardized incidence ratios (SIRs) and absolute excess risks (AERs) per 10 000 person-years based on general population rates (Continuous Morbidity Registry Nijmegen) in 476 (Dutch and Belgian) patients with aggressive non-Hodgkin lymphoma (NHL) treated with at least 6 cycles of doxorubicin-based chemotherapy in 4 European Organization for Research on Treatment of Cancer (EORTC) trials (1980-1999). Cumulative incidence of cardiovascular disease, estimated in a competing risk model, was 12% at 5 years and 22% at 10 years (median follow-up, 8.4 years). Risk of chronic heart failure appeared markedly increased (SIR, 5.4; 95% CI, 4.1-6.9) with an AER of 208 excess cases per 10 000 person-years, whereas risk of coronary artery disease matched the general population (SIR, 1.2; 95% CI, 0.8-1.8; AER, 8 per 10 000 person-years). Risk of stroke was raised (SIR, 1.8; 95% CI, 1.1-2.4; AER, 15 per 10 000 person-years), especially after additional radiotherapy (> 40 Gy). Preexisting hypertension, NHL at young age, and salvage treatment increased risk of all cardiovascular events; the effect of radiotherapy was dose dependent. In conclusion, patients are at long-term high risk of chronic heart failure after NHL treatment and need therefore life-long monitoring. In contrast, risk of coronary artery disease appeared more age dependent than treatment related. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: D. L. Hershman, R. B. McBride, A. Eisenberger, W. Y. Tsai, V. R. Grann, and J. S. Jacobson Doxorubicin, Cardiac Risk Factors, and Cardiac Toxicity in Elderly Patients With Diffuse B-Cell Non-Hodgkin's Lymphoma J. Clin. Oncol., July 1, 2008; 26(19): 3159 - 3165. [Abstract] [Full Text] [PDF] E. C. Bluhm, C. Ronckers, R. J. Hayashi, J. P. Neglia, A. C. Mertens, M. Stovall, A. T. Meadows, P. A. Mitby, J. A. Whitton, S. Hammond, et al. Cause-specific mortality and second cancer incidence after non-Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study Blood, April 15, 2008; 111(8): 4014 - 4021. [Abstract] [Full Text] [PDF] A. J. Swerdlow, C. D. Higgins, P. Smith, D. Cunningham, B. W. Hancock, A. Horwich, P. J. Hoskin, A. Lister, J. A. Radford, A. Z. S. Rohatiner, et al. Myocardial Infarction Mortality Risk After Treatment for Hodgkin Disease: A Collaborative British Cohort Study J Natl Cancer Inst, February 7, 2007; 99(3): 206 - 214. [Abstract] [Full Text] [PDF]

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