Clinical Topics   /   Oncology

Pulmonary Events Affect 30% of Hodgkin Lymphoma Patients Post-Chemo

by Annette Boyle
June 1, 2018

CHESAPEAKE, VA — Bleomycin, the first line standard of care for Hodgkin lymphoma causes pulmonary events in some patients, but physicians have been uncertain how many patients are affected and how long they remain at risk.

Researchers led by Tod A. Morris, MD, of the Naval Medical Center Portsmouth in Chesapeake, VA, provided quantifiable answers in a study released in conjunction with the 2018 American Society of Clinical Oncology Annual Meeting in Chicago this weekend.1

The retrospective cohort study analyzed data from the MHS from Jan. 1, 2005 to Dec. 31, 2013 on 642 adults diagnosed with Hodgkin lymphoma. Patients were followed until death, disenrollment or June 30, 2016. Exclusions included prior malignancies and receipt of less than two chemotherapy agents as first line treatment.

Of the 642 patients with Hodgkin lymphoma identified, 551 received bleomycin. In 85.2% of those patients, bleomycin formed part of their first line therapy, while 4.7% received bleomycin as a component of a second line regimen. New pulmonary events occurred at about the same rate in patients who received bleomycin alone, 29%, and those who received a combination of bleomycin and radiation therapy (30%). Pulmonary events included pulmonary fibrosis, pneumonitis, interstitial lung disease, pneumonia, bronchiolitis obliterans, and acute respiratory distress syndrome.

The researchers found that, while many patients experienced pulmonary events during treatment, bleomycin elevated risk of pulmonary events for up to 36 months. About 10% of all pulmonary events occurred in the first six months after bleomycin treatment, with or without radiation therapy, and 15% happened in the first year.

An additional 7% of all events in the study occurred in year two, then the rate tapered off with another 2.7% in year three, and a further 1.9% in year four, for a total of 29.6% through the entire follow up period.

“A high proportion of HL patients experienced new pulmonary events within 2 years of receiving initial treatment containing bleomycin,” study authors concluded. “While many events occurred during treatment, the majority happened up to 36 months after completion.”


1Morris TA, Feliciano J, Fox K, et al. Pulmonary events in patients with Hodgkin lymphoma after first line chemotherapy in the US Department of Defense healthcare system. J Clin Oncol 36, 2018 (suppl; abstr e22070)

Related Articles

Effective Metrics Help VA Exceed National Goal for Colorectal Cancer Screening

More Than 80% of Patients Meet Recommendations LOS ANGELES—More than four out of five veterans eligible for colorectal cancer screening have been screened, putting the largest healthcare system in the United States among the top... View Article

More Options, Better Survival for Veterans With Metastatic Pancreatic Cancer

ALBANY, NY—Pancreatic cancer remains one of the deadliest malignancies in the United States, but new therapies can extend life and improve quality of life for many patients. That is especially the case at the VA,... View Article


U.S. Medicine Recommends


More From oncology

Oncology

Effective Metrics Help VA Exceed National Goal for Colorectal Cancer Screening

More Than 80% of Patients Meet Recommendations LOS ANGELES—More than four out of five veterans eligible for colorectal cancer screening have been screened, putting the largest healthcare system in the United States among the top... View Article

Oncology

More Options, Better Survival for Veterans With Metastatic Pancreatic Cancer

ALBANY, NY—Pancreatic cancer remains one of the deadliest malignancies in the United States, but new therapies can extend life and improve quality of life for many patients. That is especially the case at the VA,... View Article

Oncology

Military Risks for Ocular Surface Squamous Neoplasia

MIAMI—While a variety of risk factors have been evaluated in ocular surface squamous neoplasia, few studies have assessed risk factors specific to the armed forces veteran population. A report in the journal Eye and Vision... View Article

Oncology

Antibiotics Appear to Inhibit Tumor Activity in CTCL

AARHUS, DENMARK—Do CD4 T cell responses to  Staphylococcus aureus inadvertently enhance neoplastic progression in models of skin cancer and cutaneous T cell lymphoma? A prospective study in the journal Blood examined that question, exploring the... View Article

Oncology

Lower Dose Cisplatin Preferable in Squamous Cell Carcinoma

PHILADELPHIA—Chemoradiotherapy is commonly used for nonoperative treatment of locally advanced head and neck squamous cell carcinoma. The issue, according to a recent study, is that the standard dose of 100 mg/m2 cisplatin every three weeks is... View Article

Facebook Comment

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up