Cardiovascular and Thyroid Late Effects in Pediatric Patients With Hodgkin Lymphoma Treated With ABVD Protocol. Issue 4 (21st May 2023)

• Record Type: Journal Article
• Authors: Ali, Nesreen; Selim, Mustafa; Salah, Zeinab; El Nabarawy, Nahla M.; Hussein, Hany; Sidhom, Iman
• Is Part Of: Journal of pediatric hematology/oncology. Volume 45:Issue 4(2023)
• Page Start: e455
• Page End: e463
• Publication Date: 2023-05-21
• Subjects: Hodgkin lymphoma survivors -- late effects -- ABVD -- radiation therapy -- cardiotoxicity; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000002638
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Background: Hodgkin lymphoma (HL) survivors are at risk of developing a range of therapy-related complications. The goal of this study is to investigate therapy-related late-effects in HL survivors. Materials and Methods: We performed a cross-sectional study on 208 HL survivors who were treated at the National Cancer Institute or at the Children Cancer Hospital Egypt with doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy. Results: Age at diagnosis ranged from 2.5 to 17.5 with a median of 8.7 years. The cumulative incidence of cardiac toxicity at 5 and 9 years were 18.7%±2.7% and 43.3%±4.4%, respectively. Preexisting cardiac abnormalities, cumulative anthracycline dose, and end of treatment cardiac status are strong predictors of late cardiotoxicity. Hypertension was observed in ~31% of patients. Young age and obesity at the time of treatment are important risk factors for hypertension. Thyroid abnormalities developed with a 5-year cumulative incidence of 2%±1%, whereas at 9 years the cumulative incidence was 27.9%±4.5%. Thyroid dysfunction was observed in 21.2% and thyroid tumors in 1.6% of cases. Subclinical hypothyroidism was the most common thyroid abnormality. Conclusions: Cardiotoxicity, hypertension, and thyroid dysfunction are frequent late effects after doxorubicin, bleomycin, vinblastine, and dacarbazine regimen, especially if combined with radiation therapy.