Article, 2024

Pulmonary diseases in patients with classical Hodgkin lymphoma relative to a matched background population: A Danish national cohort study

British Journal of Haematology, ISSN 1365-2141, 0007-1048, 10.1111/bjh.19475

Contributors

Vandtved, Julie Haugaard (Corresponding author) [1] [2] Øvlisen, Andreas Kiesbye 0000-0002-4631-9936 [1] [2] Baech, Joachim 0000-0001-8848-4879 [1] [2] Weinrich, Ulla Møller [1] [2] Severinsen, Marianne Tang 0000-0003-0996-1812 [1] [2] Maksten, Eva Futtrup 0000-0002-9338-997X [1] [2] Jakobsen, Lasse Hjort Kyneb 0000-0002-8496-5576 [2] Glimelius, Ingrid Cecilia 0000-0001-6158-3041 [3] Kamper, Peter Martin Hjørnet [4] Hutchings, Martin 0000-0003-3873-1741 [5] Specht, Lena K 0000-0002-6902-2190 [5] Dahl-Sørensen, Rasmus Bo 0000-0002-3439-316X [6] Christensen, Jacob Haaber 0000-0002-9835-4522 [7] El‐Galaly, Tarec C. [1] [2] [7] [8]

Affiliations

  1. [1] Aalborg University
    2. [NORA names: AAU Aalborg University; University; Denmark; Europe, EU; Nordic; OECD];
  2. [2] Aalborg University Hospital
    3. [NORA names: North Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD];
  3. [3] Uppsala University Hospital
    4. [NORA names: Sweden; Europe, EU; Nordic; OECD];
  4. [4] Aarhus University Hospital
    5. [NORA names: Central Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD];
  5. [5] Rigshospitalet
    6. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];

Abstract

Late toxicities can impact survivorship in patients with classical Hodgkin lymphoma (cHL) with pulmonary toxicity after bleomycin-containing chemotherapy being a concern. The incidence of pulmonary diseases was examined in this Danish population-based study. A total of 1474 adult patients with cHL treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) or BEACOPP (bleomycin, vincristine, etoposide, doxorubicin, cyclophosphamide, procarbazine and prednisone) between 2000 and 2018 were included along with 7370 age- and sex-matched comparators from the background population. Median follow-up was 8.6 years for the patients. Patients with cHL had increased risk of incident pulmonary diseases (HR 2.91 [95% CI 2.30-3.68]), with a 10-year cumulative risk of 7.4% versus 2.9% for comparators. Excess risks were observed for interstitial lung diseases (HR 15.84 [95% CI 9.35-26.84]) and chronic obstructive pulmonary disease (HR 1.99 [95% CI 1.43-2.76]), with a 10-year cumulative risk of 4.1% and 3.5% respectively for patients. No excess risk was observed for asthma (HR 0.82 [95% CI 0.43-1.56]). Risk factors for interstitial lung diseases were age ≥60 years, the presence of B-symptoms and low albumin. These findings document a significant burden of pulmonary diseases among patients with cHL and emphasize the importance of diagnostic work-up of pulmonary symptoms.

Keywords

ABVD, B symptoms, BEACOPP, Chl, Danish National Cohort Study, Danish population-based study, Hodgkin, Hodgkin lymphoma, adult patients, age, albumin, asthma, background, background population, bleomycin-containing chemotherapy, burden, burden of pulmonary disease, chemotherapy, chronic obstructive pulmonary disease, cohort study, comparator, cumulative risk, diagnostic work-up, disease, excess risk, factors, findings, follow-up, impact survivorship, incidence, incidence of pulmonary disease, increased risk, interstitial lung disease, late toxicity, lung disease, lymphoma, matched background population, median follow-up, national cohort study, obstructive pulmonary disease, patients, population, population-based study, presence, presence of B symptoms, pulmonary disease, pulmonary symptoms, pulmonary toxicity, risk, risk factors, sex-matched comparators, study, survivorship, symptoms, toxicity, years

Funders

  • Danish Cancer Society
  • Novo Nordisk Foundation

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