Five-year Survivors of Hodgkin Lymphoma Live With Greater Risk of Stroke and Transient Ischemic Attack

Survivors of Hodgkin lymphoma treated with radiation therapy face an elevated lifelong risk of cerebrovascular disease, transient ischemic attacks (TIAs) and strokes, according to a recent study of 2,201 five-year survivors of Hodgkin lymphoma.

Most of the ischemic events derive from large-artery atherosclerosis, at 36 percent, or cardioembolisms, at 24 percent, stated Marie L. De Bruin, et al, in a June 17 Journal of the National Cancer Institute article titled “Increased Risk of Stroke and Transient Ischemic Attack in 5-year Survivors of Hodgkin Lymphoma.”

De Bruin et al researched the long-term risk of cerebrovascular disease based on treatment regimens radiation therapy and/or chemotherapy. They stratified incidence by gender, age, treatment period, cerebrovascular risk factors, type of chemotherapy and the radiation field.

The incidence of stroke was 2.2 times greater for survivors compared to the general population, and the incidence of TIAs was 3.1 times greater. Radiation applied to the neck and mediastinum was an independent risk factor for ischemic cerebrovascular disease.

Physicians should consider strategies to reduce the risk associated with using radiation therapy to treat Hodgkin lymphoma, the authors concluded. In an accompanying editorial, Dan L. Longo questioned the continuing use of radiation therapy for Hodgkin lymphoma.

“Unfortunately, given the lifelong increased risks of late effects that have been documented from the use of radiation therapy, we simply cannot keep exposing patients to risk without clear benefit while we wait for safety data to be produced,” Long stated.

Both the study and the editorial can be accessed at www.jnci.oxfordjournals.org.