Adverse late outcomes in long-term survivors of young adult Hodgkin lymphoma (YAHL) compared to their unaffected co-twins.

Late-onset conditions have been reported in young adult Hodgkin lymphoma (YAHL) survivors but the use of convenience controls may bias estimates. Thirty-five YAHL survivors and their unaffected co-twins completed an online questionnaire on such conditions. McNemar's test and conditional logistic and random-effects linear regression were used to assess differences. On average, YAHL survivors (54.3% monozygotic, 57.1% female) were 27.1 years at diagnosis and 29.7 years post-diagnosis at participation. Survivors had increased risk of secondary malignancy (OR = 4.33), cardiac (12 cases/0 co-twins), lung (6 cases/0 co-twins), and thyroid conditions (18 cases/0 co-twins), and increased utilization of cardiac (OR = 9.00) and thyroid tests (OR = 10.00) compared to their co-twin. Non-significant trends in life milestone achievement, including greater college degree attainment, earlier retirement, and fewer biological children, were also observed in YAHL survivors. Life satisfaction was significantly lower among YAHL survivors (p = .035). Decades after diagnosis, differences in late outcomes were observed in YAHL survivors compared to co-twin controls, providing a more accurate assessment of the late effects of YAHL.