- SATURDAY, May 31 (HealthDay News) — People who survived Hodgkin
lymphoma as children have an increased risk of developing and dying from
another cancer or cardiovascular disease as adults, according to a new
report.

The treatment for Hodgkin — chemotherapy and radiation — may help
drive these increased risks, according to the researchers.

“The bottom-line message is that a portion of those who survive Hodgkin
lymphoma continue to have significant health needs beyond their five-year
'cure' mark,” Dr. Sharon Castellino, an assistant professor of pediatrics
at Brenner Children's Hospital, part of Wake Forest Baptist Medical
Center, said in a prepared statement. “Survivors and their doctors need to
be aware of continued risks in adulthood from treatment received more than
20 years ago.”

The study, primarily by Wake Forest researchers, was scheduled to be
presented May 31 at the annual meeting of the American Society of Clinical
Oncology, in Chicago.

Hodgkin lymphoma follows the growth of malignant cells in the lymph
system, which is part of the immune system. The disease is considered one
of the more curable types of cancer, with 90 percent of patients surviving
in the first five years of treatment.

The study followed 1,927 of these five-year Hodgkin survivors who were
diagnosed between 1970 and 1986 at a median age of 14 years. Of that
group, 320 people died: 30 percent from a recurrence of Hodgkin, 26
percent from a different cancer, and 19 percent from a cardiovascular
event such as a heart attack or stroke.

The findings linked an increased risk of premature death in the male
survivors to higher doses of chemotherapy, including anthracycline drugs.
Among females, radiation therapy — regardless of dosage — was associated
with the higher death rate.

“It hadn't been clarified until this study that there was a different
pattern of risks in men and women,” Castellino, a pediatric oncologist,
said. “Other than a recurrence of the original cancer, the leading cause
of death in women is breast cancer, and for men it is cardiovascular
events.”

New prevention recommendations, such as earlier health screenings,
could result from the findings. “Currently, women who received treatment
for the disease are advised to have mammograms as early as 25 years old,”
she said. “But, currently there are no specific guidelines for heart
disease prevention over those for the general population.”

Although radiation therapy doses given to children with Hodgkin's have
been lowered since the 1980s and techniques have been refined, Castellino
said the heart and other critical structures are often exposed to
radiation. Hodgkin's often attacks the lymph system in the chest, so
radiation usually targets the neck and upper chest area.

More information

The American Cancer Society has more about Hodgkin lymphoma.