Late Effects from Childhood and Adolescent Hodgkin Lymphoma Treatment

Children and teenagers may have treatment-related side effects that appear months or years after treatment for Hodgkin lymphoma. Because of these late effects on health and development, regular follow-up exams are important. Late effects may include problems with the following:

• Development of sex and reproductive organs.
• Fertility (ability to have children).
• Thyroid, heart, or lungs.
• An increased risk of developing a second primary cancer.
• Bone and muscle growth and development.
• Teeth, gums, and salivary glands.

For female survivors of Hodgkin lymphoma, there is an increased risk of breast cancer. This risk depends on the amount of radiation therapy they received during treatment and the chemotherapy regimen used. The risk of breast cancer is decreased when female survivors receive radiation therapy to the ovaries. It is suggested that these patients have a mammogram once a year starting 8 years after treatment or at age 25 years, whichever is later. Female survivors of childhood Hodgkin lymphoma who have breast cancer have an increased risk of dying from the disease compared to patients with no history of Hodgkin lymphoma who have breast cancer.

The risk of these long-term side effects will be considered when treatment decisions are made. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.)