JACC. Advances · 2026
Mortality in Patients With Hodgkin Lymphoma and Heart Failure: A Swedish Population-Based Study.
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Godtfredsen Sissel Johanne, Eloranta Sandra, Smedby Karin E, Antonilli Stefanie, Baech Joachim, Molin Daniel, Kragholm Kristian, El-Galaly Tarec C, Dietrich Caroline E
Аннотация
BACKGROUND: While individuals treated for classical Hodgkin lymphoma (cHL) have an increased risk of heart failure (HF), the effect on survival is less clear.
OBJECTIVES: The purpose of this study was to compare all-cause mortality following HF diagnosis between patients with prior cHL and comparators, with cardiovascular (CV)-specific mortality as an explorative outcome.
METHODS: Patients with cHL and subsequent HF were matched 1:2 with comparators with HF on sex, birth year, year of HF, and contact type (inpatient/outpatient). Follow-up began at HF and ended upon death or censoring (emigration; December 31, 2023; or maximum 5 years). HRs with 95% CIs were estimated using flexible parametric survival models adjusted for matching variables.
RESULTS: Between 2000 and 2022, 257 patients with cHL and 514 comparators were included. The median age was 73 years, and males predominated (64%). Over a median follow-up of 2.5 years for cHL and 3.3 years for comparators, respectively, 130 (51%) and 192 (37%) died. Lymphoma-related death dominated in the cHL group (40%), while CV death dominated among comparators (42%). All-cause mortality was higher for patients with HF and prior cHL than HF comparators (HR: 1.81; 95% CI: 1.44-2.26). CV-specific mortality did not differ overall (HR: 1.17; 95% CI: 0.78-1.75) except for patients with HF ≥10 years after cHL (HR: 3.13; 95% CI: 1.71-5.73).
CONCLUSIONS: cHL was associated with higher all-cause mortality following HF diagnosis. CV-specific mortality was significantly higher for patients with HF ≥10 years after cHL, possibly highlighting the impact of late treatment toxicity, although careful interpretation is warranted given the strong competing risk of lymphoma-related deaths.
OBJECTIVES: The purpose of this study was to compare all-cause mortality following HF diagnosis between patients with prior cHL and comparators, with cardiovascular (CV)-specific mortality as an explorative outcome.
METHODS: Patients with cHL and subsequent HF were matched 1:2 with comparators with HF on sex, birth year, year of HF, and contact type (inpatient/outpatient). Follow-up began at HF and ended upon death or censoring (emigration; December 31, 2023; or maximum 5 years). HRs with 95% CIs were estimated using flexible parametric survival models adjusted for matching variables.
RESULTS: Between 2000 and 2022, 257 patients with cHL and 514 comparators were included. The median age was 73 years, and males predominated (64%). Over a median follow-up of 2.5 years for cHL and 3.3 years for comparators, respectively, 130 (51%) and 192 (37%) died. Lymphoma-related death dominated in the cHL group (40%), while CV death dominated among comparators (42%). All-cause mortality was higher for patients with HF and prior cHL than HF comparators (HR: 1.81; 95% CI: 1.44-2.26). CV-specific mortality did not differ overall (HR: 1.17; 95% CI: 0.78-1.75) except for patients with HF ≥10 years after cHL (HR: 3.13; 95% CI: 1.71-5.73).
CONCLUSIONS: cHL was associated with higher all-cause mortality following HF diagnosis. CV-specific mortality was significantly higher for patients with HF ≥10 years after cHL, possibly highlighting the impact of late treatment toxicity, although careful interpretation is warranted given the strong competing risk of lymphoma-related deaths.