Impact of Preexisting Heart Failure on Treatment and Outcomes in Older Patients With Hodgkin Lymphoma.
JACC CardioOncol
; 6(2): 200-213, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38774008
ABSTRACT
Background:
Older patients with Hodgkin lymphoma (HL) often have comorbid cardiovascular disease; however, the impact of pre-existing heart failure (HF) on the management and outcomes of HL is unknown.Objectives:
The aim of this study was to assess the prevalence of pre-existing HF in older patients with HL and its impact on treatment and outcomes.Methods:
Linked Surveillance, Epidemiology, and End Results (SEER) and Medicare data from 1999 to 2016 were used to identify patients 65 years and older with newly diagnosed HL. Pre-existing HF, comorbidities, and cancer treatment were ascertained from billing codes and cause-specific mortality from SEER. The associations between pre-existing HF and cancer treatment were estimated using multivariable logistic regression. Cause-specific Cox proportional hazards models adjusted for comorbidities and cancer treatment were used to estimate the association between pre-existing HF and cause-specific mortality.Results:
Among 3,348 patients (mean age 76 ± 7 years, 48.6% women) with newly diagnosed HL, pre-existing HF was present in 437 (13.1%). Pre-existing HF was associated with a lower likelihood of using anthracycline-based chemotherapy regimens (OR 0.42; 95% CI 0.29-0.60) and a higher likelihood of lymphoma mortality (HR 1.25; 95% CI 1.06-1.46) and cardiovascular mortality (HR 2.57; 95% CI 1.96-3.36) in models adjusted for comorbidities. One-year lymphoma mortality cumulative incidence was 37.4% (95% CI 35.5%-39.5%) with pre-existing HF and 26.3% (95% CI 25.0%-27.6%) without pre-existing HF. The cardioprotective medications dexrazoxane and liposomal doxorubicin were used in only 4.2% of patients.Conclusions:
Pre-existing HF in older patients with newly diagnosed HL is common and associated with higher 1-year mortality. Strategies are needed to improve lymphoma and cardiovascular outcomes in this high-risk population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
JACC CardioOncol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos