Young Hodgkin Lymphoma Survivors Often Don’t Receive Recommended Care

Most adolescent and young adult (AYA) survivors of Hodgkin lymphoma did not receive the recommended care within the first year post-treatment, according to a study. The results were presented at the American Society of Clinical Oncology (ASCO) Cancer Survivorship Symposium held in San Francisco.

“AYAs who are diagnosed and treated for Hodgkin lymphoma have very high overall survival rates, which is fantastic,” said lead study author Erin E. Hahn, PhD, MPH, of Kaiser Permanente Southern California, during a press call in advance of the symposium. “However, they are at high risk for both short- and long-term health issues related to their cancer treatment.”

The National Comprehensive Cancer Network (NCCN) offers guidelines on post-treatment care, and this study examined adherence to those guidelines in 354 AYA survivors.

In terms of short-term care, most patients received recommended visits, lab tests, and imaging in the first year, while less than half of patients received the flu vaccine, a recommended preventive care treatment. A composite measure of all the first-year recommended items showed that only 48% of survivors received all of them.

Almost all patients (96%) had recommended oncology visits within the first 5 years, and 70% received recommended lab tests. About two-thirds of the patients received a recommended CT scan in the first year, but 47% received CT scans in years 2 and 3, which are not actually recommended by NCCN.

Looking specifically at a high-risk group of patients who were initially treated with high-dose anthracyclines, cardiac screening more than 10 years out is recommended. Among 56 such patients, almost all underwent annual blood pressure screening, but only 30% received echocardiograms and other screening modalities.

The year of diagnosis was significantly associated with receipt of recommended care, with those diagnosed between 2000 and 2005 less likely to receive the care than those diagnosed from 2006 to 2010 (P < .0001).

“This study really shows that there is a need to improve care delivery for these patients,” Hahn said, adding that there is clear opportunity to design and implement systematic programs to address these gaps in care.

Merry-Jennifer Markham, MD, of the University of Florida College of Medicine and an ASCO expert who was not involved with the study, agreed that the opportunity to improve is obvious. “Most of them will have long lives ahead of them,” she said. “Despite the guidelines, Dr. Hahn’s study illustrates that less than half…are receiving some critical components of survivorship care.”