Late cardiopulmonary morbidity in patients with Hodgkin lymphoma: a retrospective nationwide registry study

Hodgkin lymphoma (HL) is a B-cell neoplasm with a cure rate of 90%. Previous data on late morbidity in patients with HL cover the era of older treatment modalities. This real-world study consisted of 2912 patients diagnosed with HL between 2000 and 2019 in Finland and aimed to clarify the incidence of late-onset cardiopulmonary morbidity compared to matched controls. Patient data were collected from four nationwide Finnish healthcare registries. We reported a higher occurrence of coronary artery disease in patients aged < 50 years at diagnosis than in controls (RR 3.80 (2.16–6.74), p < 0001). Additionally, a higher incidence of both heart failure (RR 1.68 (1.28–2.21), p < 0.001) and valvular heart disease (RR 1.80 (1.17–2.78), p = 0.006) was detected in patients aged ≥ 50 years at diagnosis than in the controls. Remarkably, in the < 50 years age group, the incidences of pneumonia (RR 4.89 (3.58–6.71), p < 0.001) and pulmonary embolism (RR 7.78 (2.75–21.95), p < 0.001) were higher than those in the control group. In conclusion, with the current treatment modalities, late cardiopulmonary morbidity in long-term survivors remains a great challenge. A strategy for primary prevention and early detection of late toxicity remains crucial and a critical evaluation of current treatment practices is warranted.