Factors associated with risk of CH after HL diagnosis
| Variable . | All patients (N = 1096) . | Patients with preexisting heart disease (N = 96) . | ||||||
|---|---|---|---|---|---|---|---|---|
| N (%) . | HR . | 95% CI . | P . | N (%) . | HR . | 95% CI . | P . | |
| Pre-HL cardiac disease | 96 (9%) | 3.98 | 2.26-7.01 | < .001 | 96 (100%) | — | — | — |
| Pre-HL risk factors* | 160 (15%) | 1.64 | 0.98-2.74 | .061 | 35 (36%) | 1.06 | 0.53-2.12 | .873 |
| Age at HL diagnosis | 34 (18-86)¶ | 1.03# | 1.02-1.05 | < .001 | 63 (19-84)¶ | 1.00 | 0.98-1.02 | .933 |
| Sex | ||||||||
| Male | 616 (56%) | 1.67 | 1.09-2.55 | .019 | 57 (59%) | 1.97 | 0.95-4.11 | .070 |
| Female | 480 (44%) | Ref | — | — | 39 (41%) | Ref | — | — |
| Treatment†‡ | ||||||||
| Doxorubicin + MRT§ | 342 (31%) | 1.76 | 1.08-2.86 | .022 | 17 (18%) | 2.51 | 1.06-5.94 | .036 |
| MRT no chemotherapy‡ | 177 (16%) | 1.02 | 0.56-1.85 | .945 | 16 (17%) | 2.70 | 1.14-6.25 | .025 |
| Other‖ | 72 (7%) | 1.10 | 0.54-2.20 | .808 | 20 (21%) | 1.20 | 0.43-3.38 | .726 |
| Doxorubicin no MRT | 505 (46%) | Ref | — | — | 43 (45%) | Ref | — | — |
| Variable . | All patients (N = 1096) . | Patients with preexisting heart disease (N = 96) . | ||||||
|---|---|---|---|---|---|---|---|---|
| N (%) . | HR . | 95% CI . | P . | N (%) . | HR . | 95% CI . | P . | |
| Pre-HL cardiac disease | 96 (9%) | 3.98 | 2.26-7.01 | < .001 | 96 (100%) | — | — | — |
| Pre-HL risk factors* | 160 (15%) | 1.64 | 0.98-2.74 | .061 | 35 (36%) | 1.06 | 0.53-2.12 | .873 |
| Age at HL diagnosis | 34 (18-86)¶ | 1.03# | 1.02-1.05 | < .001 | 63 (19-84)¶ | 1.00 | 0.98-1.02 | .933 |
| Sex | ||||||||
| Male | 616 (56%) | 1.67 | 1.09-2.55 | .019 | 57 (59%) | 1.97 | 0.95-4.11 | .070 |
| Female | 480 (44%) | Ref | — | — | 39 (41%) | Ref | — | — |
| Treatment†‡ | ||||||||
| Doxorubicin + MRT§ | 342 (31%) | 1.76 | 1.08-2.86 | .022 | 17 (18%) | 2.51 | 1.06-5.94 | .036 |
| MRT no chemotherapy‡ | 177 (16%) | 1.02 | 0.56-1.85 | .945 | 16 (17%) | 2.70 | 1.14-6.25 | .025 |
| Other‖ | 72 (7%) | 1.10 | 0.54-2.20 | .808 | 20 (21%) | 1.20 | 0.43-3.38 | .726 |
| Doxorubicin no MRT | 505 (46%) | Ref | — | — | 43 (45%) | Ref | — | — |
Data for “All patients” show results for all subcohort patients, illustrating the significant impact of preexisting cardiac disease on the risk of CH. An interaction term between treatment and preexisting cardiac disease was significant (P = .01): the effect of MRT was significantly different between those with and without prior cardiac disease.
CI indicates confidence interval; —, not applicable; and Ref, referent group for comparison.
At least 1 of hypertension, diabetes, or elevated cholesterol.
In the subcohort, 77% of patients received doxorubicin-based chemotherapy; ABVD accounted for 61% of chemotherapy given; 74% of those receiving chemotherapy had more than or equal to 6 cycles. Among those with pre-HL cardiac disease, 63% received doxorubicin-based chemotherapy; ABVD accounted for 34% of chemotherapy given; 57% had more than or equal to 6 cycles.
Median observation times are as follows: doxorubicin + MRT, 9.4 years; doxorubicin, no MRT, 9.1 years; and MRT, no chemotherapy, 11.7 years.
Median dose of MRT = 35 Gy.
Includes nondoxorubicin chemotherapy with or without RT and non-MRT without chemotherapy.
Median (range).
HR per year.