Hodgkin Lymphoma Survivors: We Need to Do Better.
Hodgkin Lymphoma Survivors: We Need to Do Better.
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霍奇金淋巴瘤幸存者：我们需要做得更好。
DOI：
10.1093/jnci/djaa196
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Oeffinger,KevinC
中科院分区：
文献类型：
--
作者：
Henderson,TaraO;Oeffinger,KevinC
在本期杂志中，de弗里斯及其同事（1）研究了荷兰多中心霍奇金淋巴瘤幸存者队列的病因特异性晚期死亡率。虽然这项研究调查了一个已经被广泛检查的人群，我们知道霍奇金淋巴瘤具有慢性健康状况，随后的恶性肿瘤和过早死亡的高风险，但这项分析中包含的广度和细节进一步告知霍奇金淋巴瘤幸存者的护理，并支持开发新方法治疗新诊断的霍奇金淋巴瘤患者的需求。这项研究有几个重要的优势，包括大量的霍奇金病幸存者-近5000人-幸存者在广泛的年龄范围内诊断，包括儿童，青少年和青年到中年（1）。此外，该队列的诊断时间跨度为3.5年，从1965年到2000年，使研究人员能够检查反映霍奇金淋巴瘤治疗方法实质性变化的特定治疗时代。研究人员使用癌症治疗暴露数据来探索与病因特异性死亡率的相关性。这项研究令人清醒的发现是，到54岁时，霍奇金淋巴瘤幸存者的非霍奇金病因累积死亡率与71岁的普通人群相似[1]。换句话说，不仅最初的癌症对个体是一种威胁，而且在癌症幸存下来之后，治愈性治疗的后期效应大大缩短了一个人的寿命。重要的是，最常见的死亡原因可能是可以通过早期诊断实体瘤、预防和早期检测心血管疾病以及对无脾或脾功能障碍个体进行适当管理来预防的。令人失望的是，尽管霍奇金淋巴瘤的死亡率从20世纪60年代到90年代急剧下降，但由于随后的实体瘤和心血管疾病导致的死亡率并没有多大改善。这提醒我们，治疗的强度，特别是使用放射治疗，是有害的;这确实是一个脆弱的人口。这项研究的一个重要发现是，尽管被诊断为
In this issue of the Journal, de Vries and colleagues (1) examined the cause-specific late mortality among a multicenter Dutch cohort of Hodgkin lymphoma survivors. Although this study examines a population that has been extensively examined, and we know Hodgkin lymphoma carries a high risk of chronic health conditions, subsequent malignant neoplasms, and premature mortality, the breadth and details included in this analysis further inform care of Hodgkin lymphoma survivors and support the need for the development of novel approaches to treat patients with newly diagnosed Hodgkin lymphoma. This study has several important strengths, including a large number of Hodgkin survivors—almost 5000—with survivors diagnosed across a wide age spectrum, including childhood, adolescence, and young to mid-adulthood (1). Further, the cohort was diagnosed over a span of 3.5 decades, from 1965 to 2000, allowing the investigators to examine specific treatment eras that reflected substantial changes in the approach to Hodgkin lymphoma therapy. The investigators used cancer treatment exposure data to explore associations with cause-specific mortality.The sobering finding from this study is that by the age of 54years, Hodgkin lymphoma survivors had a cumulative mortality from non-Hodgkin causes that was similar to that of a 71-year-old in the general population (1). In other words, not only is the original cancer a threat to an individual but, after surviving the cancer, the late effects of the curative therapy substantially shorten one’s life span. Importantly, the most common causes of death are potentially preventable with early diagnosis of solid tumors, prevention, and early detection of cardiovascular disease and appropriate management of individuals with asplenia or splenic dysfunction. It was a bit disappointing to observe that although mortality from Hodgkin lymphoma has dramatically declined from the 1960s to the 1990s, mortality due to subsequent solid tumors and cardiovascular disease has not improved much. This reminds us that the intensity of therapy, particularly the use of radiotherapy, necessary to achieve a cure is toxic; this is indeed a vulnerable population. An important finding of the study is that although individuals diagnosed in
影响因子：
28.4
作者：
Broeckelmann, Paul J.;Goergen, Helen;Engert, Andreas
通讯作者：
Engert, Andreas
影响因子：
20.3
作者：
Herrera, Alex F.;Moskowitz, Alison J.;Advani, Ranjana H.
通讯作者：
Advani, Ranjana H.