Cardiovascular disease risks in younger versus older adult B-cell non-Hodgkin's lymphoma survivors

Cancer Med. 2021 Jun;10(12):4117-4126. doi: 10.1002/cam4.3934. Epub 2021 May 12.

Abstract

Introduction: Young cancer survivors may be at increased risk of early-onset chronic health conditions. The aim of this population-based study is to estimate cardiovascular disease (CVD) risk among younger versus older B-cell non-Hodgkin's lymphoma (B-NHL) survivors compared with their respective general population cohorts.

Methods: B-NHL survivors diagnosed from 1997 to 2015 in the Utah Cancer Registry were matched with up to five cancer-free individuals on birth year, sex, and birth state, using the statewide Utah Population Database. Electronic medical records and statewide health care facility data were used to identify disease outcomes ≥5 years after cancer diagnosis. Cox Proportional Hazards models were used to estimate hazard ratios for B-NHL survivors diagnosed at <65 years and ≥65 years old.

Results: Younger B-NHL survivors had higher relative risks than older cancer survivors of chronic rheumatic disease of the heart valves (HR = 4.14, 99% CI = 2.17-7.89; P valueheterogeneity = 0.004); peri-, endo-, and myocarditis (HR = 2.43, 99% CI = 1.38-4.28; P valueheterogeneity = 0.016); diseases of the arteries (HR = 1.63, 99% CI = 1.21-2.21; P valueheterogeneity = 0.044); and hypotension (HR = 2.44, 99% CI = 1.58-3.75; P valueheterogeneity = 0.048). B-NHL survivors of both age groups had elevated relative risks of heart disease overall and congestive heart failure.

Conclusion: Younger B-NHL survivors had higher risks than older B-NHL survivors of specific cardiovascular diseases compared to their respective general population cohorts.

Keywords: accelerated aging; cardiovascular disease; long-term health; non-Hodgkin's lymphoma; survivorship.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cancer Survivors*
  • Cardiovascular Diseases / etiology*
  • Female
  • Heart Disease Risk Factors*
  • Heart Diseases / etiology
  • Heart Failure / etiology
  • Heart Valve Diseases / etiology
  • Humans
  • Hypotension / etiology
  • Lymphoma, B-Cell / complications*
  • Male
  • Middle Aged
  • Myocarditis / etiology
  • Proportional Hazards Models
  • Registries
  • Rheumatic Heart Disease / etiology
  • Utah
  • Vascular Diseases / etiology
  • Young Adult