PMID- 32946352
OWN - NLM
STAT- MEDLINE
DCOM- 20210324
LR  - 20211211
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 38
IP  - 35
DP  - 2020 Dec 10
TI  - Cause-Specific Mortality Following Initial Chemotherapy in a Population-Based 
      Cohort of Patients With Classical Hodgkin Lymphoma, 2000-2016.
PG  - 4149-4162
LID - 10.1200/JCO.20.00264 [doi]
AB  - PURPOSE: Mortality for patients with classical Hodgkin lymphoma (cHL) treated 
      during an era characterized in the United States by widespread use of 
      doxorubicin, bleomycin, vinblastine, and dacarbazine and diminishing use of 
      radiotherapy is not well understood. PATIENTS AND METHODS: We identified 20,007 
      individuals diagnosed with stage I/II (early) or III/IV (advanced) cHL between 
      age 20 and 74 years treated with initial chemotherapy in US population-based 
      cancer registries during 2000-2015 (follow-up through 2016). We used standardized 
      mortality ratios (SMRs) to compare cause-specific relative mortality risk 
      following cHL to that expected in the general population and estimated excess 
      absolute risks (EARs; per 10,000 patient-years) to quantify disease-specific 
      death burden. RESULTS: We identified 3,380 deaths in the cHL cohort, including 
      1,321 (39%) not attributed to lymphoma. Overall, noncancer SMRs were increased 
      2.4-fold (95% CI, 2.2 to 2.6; observed, 559; EAR, 61.6) and 1.6-fold (95% CI, 1.4 
      to 1.7; observed, 473; EAR, 18.2) for advanced- and early-stage cHL, 
      respectively, compared with the general US population. SMRs and EARs differed 
      substantially by cause of death and cHL stage. Among the highest EARs for 
      noncancer causes of death were those for heart disease (EAR, 15.1; SMR, 2.1), 
      infections (EAR, 10.6; SMR, 3.9), interstitial lung disease (ILD; EAR, 9.7; SMR, 
      22.1), and adverse events (AEs) related to medications/drugs (EAR, 7.4; SMR, 5.0) 
      after advanced-stage cHL and heart disease (EAR, 6.6; SMR, 1.7), ILD (EAR, 3.7; 
      SMR, 13.1), and infections (EAR, 3.1; SMR, 2.2) after early-stage cHL. Strikingly 
      elevated SMRs for ILD, infections, and AEs were observed < 1 year after cHL. 
      Individuals age 60-74 years with advanced-stage cHL experienced a 
      disproportionate excess of deaths as a result of heart disease, ILD, infections, 
      AEs, and solid tumors. CONCLUSION: Despite evolving cHL treatment approaches, 
      patients continue to face increased nonlymphoma mortality risks from multiple, 
      potentially preventable causes. Surveillance, early interventions, and cHL 
      treatment refinements may favorably affect patient longevity, particularly among 
      high-risk subgroups.
FAU - Dores, Graca M
AU  - Dores GM
AD  - Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 
      National Cancer Institute, National Institutes of Health, Department of Health 
      and Human Services, Bethesda, MD.
AD  - US Food and Drug Administration, Center for Biologics Evaluation and Research, 
      Office of Biostatistics and Epidemiology, Silver Spring, MD.
FAU - Curtis, Rochelle E
AU  - Curtis RE
AD  - Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 
      National Cancer Institute, National Institutes of Health, Department of Health 
      and Human Services, Bethesda, MD.
FAU - Dalal, Nicole H
AU  - Dalal NH
AD  - Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 
      National Cancer Institute, National Institutes of Health, Department of Health 
      and Human Services, Bethesda, MD.
AD  - Duke University School of Medicine, Durham, NC.
FAU - Linet, Martha S
AU  - Linet MS
AD  - Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 
      National Cancer Institute, National Institutes of Health, Department of Health 
      and Human Services, Bethesda, MD.
FAU - Morton, Lindsay M
AU  - Morton LM
AD  - Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 
      National Cancer Institute, National Institutes of Health, Department of Health 
      and Human Services, Bethesda, MD.
LA  - eng
GR  - ZIA CP010131/ImNIH/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200918
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
CIN - J Clin Oncol. 2020 Dec 10;38(35):4131-4134. PMID: 33030980
MH  - Adult
MH  - Aged
MH  - Cause of Death
MH  - Cohort Studies
MH  - Female
MH  - Hodgkin Disease/*drug therapy/*mortality/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Registries
MH  - SEER Program
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC7723686
EDAT- 2020/09/19 06:00
MHDA- 2021/03/25 06:00
PMCR- 2021/12/10
CRDT- 2020/09/18 17:11
PHST- 2020/09/19 06:00 [pubmed]
PHST- 2021/03/25 06:00 [medline]
PHST- 2020/09/18 17:11 [entrez]
PHST- 2021/12/10 00:00 [pmc-release]
AID - 2000264 [pii]
AID - 10.1200/JCO.20.00264 [doi]
PST - ppublish
SO  - J Clin Oncol. 2020 Dec 10;38(35):4149-4162. doi: 10.1200/JCO.20.00264. Epub 2020 
      Sep 18.