Late complications after treatment for Hodgkin lymphoma.

Long-term survivors of Hodgkin lymphoma face a number of late effects that can significantly affect the length and quality of their life. These include increased risk of second malignancy, cardiovascular disease, pulmonary dysfunction, infections, and endocrinopathy. Of these late effects, second malignancies and cardiac disease are the two leading contributors to the excess mortality seen in long-term Hodgkin lymphoma survivors. An improved understanding of the range of late complications after Hodgkin lymphoma therapy and the identification of treatment-related and patient-related risk factors can guide the development of screening and prevention programs for long-term survivors who have completed treatment. In addition, increasing recognition of late complications has in part led to substantial changes in the treatment of Hodgkin lymphoma over the years. Continued long-term follow-up of patients treated with modern therapy and documentation of late effects associated with newer treatment will be essential.