Hodgkin's disease therapy ups heart attack risk

NEW YORK, Feb 7 (Reuters) Survivors of Hodgkin's lymphoma are at increased risk of having a fatal heart attack for up to 25 years after undergoing treatment, a British research team reports.

The risk is related to heart damage caused by radiation therapy of the chest and specific chemotherapy agents, the researchers report in the Journal of the National Cancer Institute.

Dr Anthony J Swerdlow, from the Institute of Cancer Research, Sutton, and his associates extracted data from the British National Lymphoma Investigation and private databases of several hospitals. The earliest that patients were registered was 1967, with follow-up usually lasting until 2000.

The study included 7033 patients, among whom 2441 died during an average follow-up of 11 years. Heart attack was the cause of death in 166 patients. This represents a 2.5-times higher risk of a fatal heart attack compared with the general population.

''We found that the risk of death from (heart attack) was high in the year after first treatment, peaked 15-19 years after treatment was first received and remained statistically significantly increased 20-24 years after treatment, with some evidence suggesting that the increased risk may persist for even 25 years or longer after treatment,'' the researchers write.

Any type of radiotherapy above the diaphragm was associated with increased heart-related mortality, Swerdlow's team found.

Any regimen that contained an anthracycline type of chemo drug or vincristine was associated with increased risk.

However, the likelihood of a fatal heart attack declined as age at first treatment increased, and as patients aged, they report.

''The goal of keeping these patients alive has been achieved,'' Dr John D Boice, Jr of Vanderbilt University in Nashville, comments in an editorial.

However, he adds, ''The effects of treatment for Hodgkin lymphoma appear to be life-long, and cancer survivors should be monitored for late cardiac abnormalities throughout their lives.'' REUTERS RL VV0911