From 1970 to 1999, the incidence of serious chronic health conditions decreased among survivors of pediatric Hodgkin lymphoma (HL), according to the results of a study published in the Journal of Clinical Oncology.
Modern treatment of HL has focused more on reducing the risk of long-term and late adverse events, given the high cure rates among pediatric patients. The authors proposed that the aim of this study was to “determine whether the risk of serious outcomes [has] been reduced with changes in [HL] therapy.”
The study evaluated data from 2996 pediatric HL survivors diagnosed between 1970 and 1999 from the Childhood Cancer Survivor Study. Severe to fatal chronic conditions were considered grade 3 to 5 and were based on self-reported conditions, confirmed second neoplasms, and death.
The mean age of the cohort was 35.6 years; 47.4% were female, and the majority were non-Hispanic White.
By age 35 years, the overall cumulative incidence of grade 3 to 5 chronic conditions was 31.4%, with females at greater risk for developing a grade 3 to 5 condition (hazard ratio [HR], 2.1; 95% CI, 1.8-2.4). The cumulative incidence for a grade 3 to 5 chronic health condition by age 30 years was highest among patients treated with salvage therapy (29.0%), followed by patients who received chest radiation therapy at a dose of 35 Gy or higher (25.1%), patients who received contemporary therapy (14.5%), and those who received an anthracycline plus alkylator and no chest radiation (8.3%).
Treatment from 1990 to 1999 was associated with a significant decrease in any chronic condition compared with treatment from 1970 to 1989 (HR, 0.8; 95% CI, 0.70-0.9).
The authors concluded that “Findings from this study can help guide upfront therapy and monitoring for late effects, as well as better understand some of the potential long-term tradeoffs of various cancer therapies.”
Oeffinger KC, Stratton KL, Hudson MM, et al. Impact of risk-adapted therapy for pediatric Hodgkin lymphoma on risk of long-term morbidity: a report from the Childhood Cancer Survivor Study. J Clin Oncol. Published online February 25, 2021. doi:10.1200/JCO.20.01186