International journal of adolescent medicine and health · 2025
From cure to care-understanding long-term health risks after Hodgkin's lymphoma treatment in adolescents and young adults.
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Kearney Maeve, Faithfull Sara, Leech Michelle
Аннотация
OBJECTIVES: Hodgkin's Lymphoma (HL) is the most common malignancy among Adolescents and Young Adults (AYAs). Although survival rates are excellent, two thirds of survivors experience physical and psychosocial late effects that can emerge years or decades after treatment significantly impacting quality of life. As care priorities shift from cure to survivorship, it is essential that health care professionals (HCPs)-across oncology, primary care, mental health, and general medical services-are equipped to recognise, anticipate, and respond to these long-term consequences. This narrative review examined the evolution of HL treatment in AYAs and explored how these changes influence late-effect risks, with the aim of informing HCP vigilance and clinical practice.
METHODS: A narrative review of clinical studies, guidelines, and review literature was conducted to evaluate changes in radiotherapy and chemotherapy strategies, including treatment de-escalation, risk-adapted regimens, and advances in radiotherapy targeting. Literature and long-term population studies describing late effects, such as secondary malignancies, cardiopulmonary toxicity, endocrine disorders, and psychosocial challenges, was synthesised to identify patterns of late effects presenting in this group.
RESULTS: Findings demonstrate a clear evolution toward less intensive and more individualised treatments; however, substantial late-effect risks persist. Limited long-term outcome data reflective of contemporary treatment approaches further complicate timely recognition of these late effects.
CONCLUSIONS: Despite major therapeutic advances, AYAs remain vulnerable to long-term and late-presenting consequences of HL treatment. All HCPs who may encounter these individuals must maintain vigilant for late effects and deliver proactive, informed care that supports their sustained physical and psychological well-being.
METHODS: A narrative review of clinical studies, guidelines, and review literature was conducted to evaluate changes in radiotherapy and chemotherapy strategies, including treatment de-escalation, risk-adapted regimens, and advances in radiotherapy targeting. Literature and long-term population studies describing late effects, such as secondary malignancies, cardiopulmonary toxicity, endocrine disorders, and psychosocial challenges, was synthesised to identify patterns of late effects presenting in this group.
RESULTS: Findings demonstrate a clear evolution toward less intensive and more individualised treatments; however, substantial late-effect risks persist. Limited long-term outcome data reflective of contemporary treatment approaches further complicate timely recognition of these late effects.
CONCLUSIONS: Despite major therapeutic advances, AYAs remain vulnerable to long-term and late-presenting consequences of HL treatment. All HCPs who may encounter these individuals must maintain vigilant for late effects and deliver proactive, informed care that supports their sustained physical and psychological well-being.