J Clin Oncol: Changes in mortality from classic Hodgkin's lymphoma, 2000-2015.

In an era of widespread use of ammoxin, bolemycin, chlorpyridoxine and dakabazine, radiotherapy applications were reduced, and mortality rates for patients with classic Hodgkin's lymphoma (cHL) were not clearly counted.
study aims to analyze 20,007 patients aged I/II (early) or III/IV (late) cHL who were treated with initial chemotherapy between 2000 and 2015 in the US cancer registry.
standard mortality (SMRs) is used to compare mortality from specific causes and mortality in general, and to estimate the absolute risk of death from specific diseases (EARs, per 10,000 patient years).
3,380 deaths were identified in the cHL queue, including 1,321 (39%) not attributable to lymphoma.
, non-cancer SMRs in late and early cHL increased 2.4 times (95% CI, 2.2-2.6; EAR 61.6) and 1.6 times (1.4-1.7; 18.2)。
SMR and EAR vary widely in cause of death and cHL phases.
of non-cancer deaths after late cHL was heart disease (EAR, 15.1; SMR, 2.1), infection (EAR, 10.6; SMR, 3.9), interpulmonary disease (ILD; EAR, 9.7; SMR, 22.1) and drug-related adverse reactions (AE, EAR, 7.4; SMR, 5.0); the highest cause of non-cancer death after early cHL was heart disease (EAR, 6.6; SMR, 1.7), ILD (EAR, 3.7; SMR, 13.1) and infection (EAR, 3.1; SMR, 2.2).
significant increase in ID, infection and AE SMR was observed within 1 year of cHL.
rate of deaths from heart disease, ILD, infection, AE and solid tumors is higher in patients aged 60-74 with advanced cHL.
treatments for cHL continue to evolve, patients still face an increased risk of non-lymphoma death from a variety of potentially preventable causes.
monitoring, early intervention and improvements in cHL treatment may all contribute to longer life expectancy, especially for patients at high risk.
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