Key result
Anthracycline-containing treatment for classical Hodgkin lymphoma was associated with a higher rate of congestive heart failure compared to matched controls (HR 3.02; 95% CI 2.26-4.02).
Why the study?
Although congestive heart failure is a known complication after anthracyclines and radiotherapy for classical Hodgkin lymphoma, contemporary treatment may carry less risk due to substantial changes in radiotherapy use and techniques.
Does anthracycline-containing treatment for classical Hodgkin lymphoma increase the risk of congestive heart failure compared to the general population?
Cohort (n=1,994)
Does anthracycline-containing treatment for classical Hodgkin lymphoma increase the risk of congestive heart failure compared to the general population?
Hazard Ratio: 3.02 (95% CI 2.26–4.02)
Classical Hodgkin lymphoma survivors treated with modern anthracycline regimens continue to face a substantially increased risk of congestive heart failure compared to the general population.
Reinforces cardiac surveillance needs in Hodgkin lymphoma survivors; leaves open optimal anthracycline dosing for prospective trials.
Introduction Congestive heart failure (CHF) is a known complication after anthracyclines and radiotherapy for classical Hodgkin lymphoma (cHL). Contemporary cHL treatment may be associated with less risk because radiotherapy use and techniques have changed substantially over time. Methods In this study, Swedish cHL patients diagnosed in 2000–2018, and treated with adriamycin [doxorubicin], bleomycin, vinblastine, and dacarbazine (ABVD) or bleomycin, etoposide, Adriamycin [doxorubicin], cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), were matched 1:10 to the general population on birth year and sex to investigate relative rates and cumulative risks of CHF. Results A total of 1994 cHL patients were included, with a median age of 34 years. The median follow‐up was 8.1 years. The CHF rate was higher for patients versus comparators (adjusted hazard ratio [HR] = 3.02, 95% confidence interval [CI]: 2.26–4.02). Patients treated with ≤200 mg/m 2 of anthracyclines had HR of 2.89 (95% CI: 1.51–3.47) versus 3.91 (95% CI: 2.72–5.60) for >200 mg/m 2 . Treatment with ABVD was associated with a significantly higher CHF rate (adjusted HR = 3.25, 95% CI: 2.31–4.23), while BEACOPP was not (adjusted HR = 1.95, 95% CI: 0.91–4.16). The increase in relative rates translated to the absolute scale, with an increased risk persisting up to 18 years for low cumulative doses. Conclusion These findings highlight that cHL survivors still face a substantial excess risk of CHF in the modern treatment era and that focus on cardiovascular health remains relevant.
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Bæch et al. (2024) conducted a cohort in classical Hodgkin lymphoma (cHL) (n=1,994). Anthracycline-containing treatment (ABVD or BEACOPP) vs. General population matched on birth year and sex was evaluated on Congestive heart failure (CHF) (HR 3.02, 95% CI 2.26-4.02). Anthracycline-containing treatment for classical Hodgkin lymphoma was associated with a higher rate of congestive heart failure compared to matched controls (HR 3.02; 95% CI 2.26-4.02).
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