De Bruin, M. L. et al. Increased risk of stroke and transient ischemic attack in 5-year survivors of Hodgkin lymphoma. J. Natl Cancer Inst. 101, 928–937 (2009).

Survival of patients with Hodgkin lymphoma has improved considerably; however, young adult survivors of this disease who received radiotherapy and chemotherapy have an increased risk of stroke and transient ischemic attack (TIA). A retrospective study of the incidence of these events in a large cohort of Hodgkin lymphoma survivors has now confirmed that patients who received radiation to the neck and mediastinum have a particularly high risk of stroke and TIA.

Participants were 2,201 5-year survivors of Hodgkin lymphoma treated at four centers in The Netherlands during 1965–1995. After a median follow-up of 17.5 years, 96 patients developed a stroke or TIA and 88 developed at least one ischemic stroke or TIA when ischemic events were considered. Hodgkin lymphoma survivors had an approximately twofold increase in risk of stroke and a threefold increase in risk of TIA compared with the general population.

Over the 30-year study period, the cumulative incidence of stroke or TIA was 7%. Treatment with chemotherapy did not increase ischemic cerebrovascular risk. Hypertension, hypercholesterolemia and diabetes mellitus were associated with ischemic cerebrovascular risk but smoking and high BMI were not. The researchers concluded that survivors of Hodgkin lymphoma have a substantially increased risk of stroke and TIA for a long period after treatment.