Cardiovascular and Oncologic Considerations in Adult Hodgkin Lymphoma: JACC: CardioOncology State-of the-Art Review.

Abstract

Classic Hodgkin lymphoma is a highly curable lymphoma that affects primarily younger patients. The therapeutic landscape has evolved and generally consists of varying combinations of chemotherapy and immunotherapy as well as radiation in selected cases. Although most patients are cured of their lymphoma, there is a risk for late treatment-related cardiotoxicity that affects long-term survival and quality of life in this population. Careful consideration of baseline cardiac function and risk factors should be undertaken prior to proceeding with anthracycline-based therapies or thoracic radiation, as adjuvant cardiac-focused efforts may serve to mitigate the risk for cardiovascular dysfunction in this population. This review outlines the evidence supporting current recommendations for assessing baseline cardiotoxicity risk, implementing risk reduction strategies and treatment modifications, the role of multidisciplinary evaluation in high-risk patients, and strategies for long-term cardiac monitoring to minimize treatment-related cardiac morbidity and mortality.