Hodgkin’s Survivors at Increased Risk of Stroke

Posted on June 24th, 2009 by

Hodgkin’s Survivors at Increased Risk of Stroke

Patients who have been treated with radiation therapy for Hodgkin’s lymphoma have an elevated risk of stroke. These results were published in the Journal of the National Cancer Institute.

Hodgkin’s lymphoma is a cancer of the lymph system and is diagnosed by the identification of a characteristic cell under the microscope (the Reed-Sternberg cell). Hodgkin’s lymphoma typically begins in the lymph nodes in one region of the body and then spreads through the lymph system in a predictable manner. It may spread outside the lymph system to other organs such as the lungs, liver, bone, and bone marrow.

Treatment of Hodgkin’s lymphoma may include chemotherapy, radiation therapy, or a combination of these approaches. These treatments cure many patients, but the long-term side effects of treatment are an ongoing focus of research.

A stroke happens when blood flow to part of the brain is interrupted. The most common type of stroke is an ischemic stroke, in which a blood clot blocks a vessel in the brain. The other type of stroke is a hemorrhagic stroke, in which a blood vessel breaks and bleeds into the brain.

A transient ischemic attack (TIA), sometimes called a “mini-stroke”, happens when the blood supply to the brain is only briefly interrupted.

To explore the risk of stroke and TIA among survivors of Hodgkin’s lymphoma, researchers in the Netherlands collected information about 2,201 patients. The patients had been diagnosed between 1965 and 1995, were under the age of 51 at the time of diagnosis, and had survived for at least five years after diagnosis. The risk of stroke and TIA in these patients was compared to the risk in the general Dutch population.

  • The risk of stroke was roughly twice as high in the Hodgkin’s survivors as in the general population. The risk of TIA was three times as high in the Hodgkin’s survivors.
  • An estimated 7% of Hodgkin’s survivors experienced a stroke or TIA during the 30 years following treatment.
  • Radiation to the neck and mediastinum (the central part of the chest) increased the risk of stroke and TIA, but chemotherapy did not.
  • High blood pressure also increased the risk of stroke.

Patients who have been treated with radiation therapy for Hodgkin’s lymphoma may wish to talk with their doctor about how to reduce their risk of stroke.

Reference:

De Bruin ML, Dorresteijn LDA, van’t Veer MB et al. Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin Lymphoma. Journal of the National Cancer Institute. 2009;101:928-937.

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