Use of recommended posttreatment services for adolescent and young adult survivors of Hodgkin lymphoma

Abstract

Background Hodgkin lymphoma (HL) is a leading cancer diagnosis for adolescents and young adults (AYAs), with an overall 5‐year survival rate of >80%. However, to the authors’ knowledge, little is known regarding posttreatment patterns of care. In the current study, the authors characterized the use of guideline‐recommended services in a cohort of AYA survivors of HL in Kaiser Permanente Southern California. Methods Patients with HL who were diagnosed between ages 15 and 39 years between 2000 and 2010 were identified. The authors calculated the number of patients who received recommended short‐term care within 2 years after treatment cessation for those who remained enrolled and alive from 2001 through 2015. Use of recommended late‐effects screening for breast cancer and cardiovascular disease was examined. Logistic regression was used to evaluate the association between receipt of recommended care and patient, cancer, and treatment characteristics. Results A total of 354 patients were identified, with a mean age at the time of diagnosis of 26 years (standard deviation, 6.9 years). Approximately 12% of patients had stage I disease, 59% had stage II disease, 17% had stage III disease, and 13% of patients had stage IV disease. Nearly all patients received chemotherapy (95%), 51% received radiotherapy, and 5% received care from a pediatric oncologist. Overall, approximately 49% of patients received recommended short‐term care. Of those patients eligible for cardiovascular screening at 10 years posttreatment (60 patients), 53% received at least 1 screening. Of those patients eligible for breast cancer screening (21 patients), approximately 50% underwent at least 1 screening. Regression results indicated that those patients treated by a pediatric oncologist were >3 times as likely to receive recommended short‐term care. Conclusions The results of the current study highlight gaps in the delivery of posttreatment care to AYA survivors of HL. By determining areas in need of improvement, these findings can guide the development of tailored interventions with which to improve care.

Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols

“…Given the very favorable survival rates achieved in the last decade in AYAs affected by HL, future studies should focus not only on treatment efficacy but also on identifying the best approaches, in terms of a better quality of life during therapy and reduced long-term negative side effects [ 53 , 54 , 55 , 56 ]. The choice of OS as the only parameter defining outcome excludes relapses or long-term harmful effects that profoundly affect the quality of life [ 57 ].…”

Cardiac Screening for Childhood Cancer Survivors Can Be Improved With Existing Technology

“…This is particularly relevant because clinical guideline compliance is often used to evaluate health system performance. 13,14 Given the uncertainty about the best screening schedule, some reasonable flexibility in recommended screening frequency seems appropriate.…”

Closing the survivorship gap in children and adolescents with Hodgkin lymphoma

“…Gaps in post‐treatment care are known for HL survivors (Hahn et al , ). A Dutch initiative facilitates reimbursed targeted survivorship care for HL survivors based on national guidelines (http://www.beternahodgkin.nl) which include online calculators to generate risk‐, gender‐ and age‐based care.…”