Survival After Diagnosis of Cardiovascular Disease in Survivors of Adolescent and Young Adult Lymphoma

Cardiac dysfunction is a major morbidity among survivors of adolescent and young adult (AYA) lymphoma. Although high mortality after cardiovascular disease (CVD) diagnosis has been shown in other cancer survivor populations, this has not been investigated in a diverse population of survivors of AYA lymphoma. Therefore, in this study we evaluated survival after a diagnosis of CVD and investigated differences in the CVD-survival relationship. Demographics, treatment variables, and CVD diagnoses occurring at least 3 months after their lymphoma diagnosis were collected in a diverse population of AYA lymphoma survivors (N = 825; race/ethnicity: 58.5% White, 26.9% Hispanic, 14.5% Black). Nearly 25% (23.6%; N = 195) had a CVD diagnosis during the median follow-up time of 9.8 years with the median age at CVD diagnosis being 33.0 years. In Cox models with CVD as a time-varying covariate, the development of a CVD was highly associated with inferior survival (HR: 7.11, 95% CI: [4.03–12.5]). This adverse CVD-survival relationship was consistently observed among patient subpopulations; however, the magnitudes of the adverse effect of CVD on survival were most pronounced (HR > 7) among Black and Hispanic patients, NHL survivors, and those with a healthy baseline BMI. Together these findings underscore the need for cardiovascular health surveillance among survivors of AYA lymphoma to potentially mitigate this adverse effect of CVD on survival in this at-risk population.