Multivariable model of predictors of mortality from any cause in 5-year survivors of childhood Hodgkin lymphoma*
| Variable . | HR of death from any cause . | 95% CI . | P . |
|---|---|---|---|
| Age at diagnosis | |||
| < 10 y (reference) | 1.0 | ||
| 10-14 y | 0.9 | 0.5-1.6 | .68 |
| 15-21 y | 1.1 | 0.6-2.0 | .82 |
| Race | |||
| Other (reference) | 1.0 | ||
| White not Hispanic | 1.3 | 0.8-2.3 | .26 |
| Household Income | |||
| ≥ $20 000 (reference) | 1.0 | ||
| < $20 000 | 2.4 | 1.6-3.5 | < .01 |
| Education | |||
| After high school (reference) | 1.0 | ||
| <High school | 1.6 | 1.1-2.2 | .01 |
| Radiation field + dose | |||
| No radiation (reference) | 1.0 | ||
| Supradiaphragm, < 30 Gy† | 0.9 | 0.2-4.6 | .92 |
| Supradiaphragm, ≥ 30 Gy† | 3.8 | 1.1-12.6 | .03 |
| Infradiaphragm or Infra diaphragm + supradiaphragm, < 30 Gy† | 3.9 | 1.1-13.9 | .04 |
| Infradiaphragm or Infradiaphragm + supradiaphragm, ≥ 30 Gy | 7.8 | 2.4-25.1 | < .01 |
| Chemotherapy | |||
| Anthracycline score | |||
| 0 (reference) | 1.0 | ||
| 1 | 1.9 | 1.1-3.2 | .02 |
| 2 | 2.6 | 1.6-4.3 | < .01 |
| 3 | 4.4 | 1.9-10.1 | < .01 |
| Alkylating agent | |||
| No (reference) | 1.0 | ||
| Yes | 1.7 | 1.2-2.5 | < .01 |
| Grade 3-5 CV condition | |||
| No (reference) | 1.0 | ||
| Yes | 4.4 | 2.7-7.3 | < .01 |
| NMSC | |||
| No (reference) | 1.0 | ||
| Yes | 0.1 | 0.04-0.40 | < .01 |
| SMN within sex stratum | |||
| Female no SMN (female reference) | 1.0 | ||
| Female with breast cancer | 0.7 | 0.3-1.6 | .38 |
| Female with non breast cancer SMN | 2.6 | 1.4-5.1 | < .01 |
| Male, no SMN (male reference) | 1.0 | ||
| Male with SMN | 2.3 | 1.4-3.9 | < .01 |
| Variable . | HR of death from any cause . | 95% CI . | P . |
|---|---|---|---|
| Age at diagnosis | |||
| < 10 y (reference) | 1.0 | ||
| 10-14 y | 0.9 | 0.5-1.6 | .68 |
| 15-21 y | 1.1 | 0.6-2.0 | .82 |
| Race | |||
| Other (reference) | 1.0 | ||
| White not Hispanic | 1.3 | 0.8-2.3 | .26 |
| Household Income | |||
| ≥ $20 000 (reference) | 1.0 | ||
| < $20 000 | 2.4 | 1.6-3.5 | < .01 |
| Education | |||
| After high school (reference) | 1.0 | ||
| <High school | 1.6 | 1.1-2.2 | .01 |
| Radiation field + dose | |||
| No radiation (reference) | 1.0 | ||
| Supradiaphragm, < 30 Gy† | 0.9 | 0.2-4.6 | .92 |
| Supradiaphragm, ≥ 30 Gy† | 3.8 | 1.1-12.6 | .03 |
| Infradiaphragm or Infra diaphragm + supradiaphragm, < 30 Gy† | 3.9 | 1.1-13.9 | .04 |
| Infradiaphragm or Infradiaphragm + supradiaphragm, ≥ 30 Gy | 7.8 | 2.4-25.1 | < .01 |
| Chemotherapy | |||
| Anthracycline score | |||
| 0 (reference) | 1.0 | ||
| 1 | 1.9 | 1.1-3.2 | .02 |
| 2 | 2.6 | 1.6-4.3 | < .01 |
| 3 | 4.4 | 1.9-10.1 | < .01 |
| Alkylating agent | |||
| No (reference) | 1.0 | ||
| Yes | 1.7 | 1.2-2.5 | < .01 |
| Grade 3-5 CV condition | |||
| No (reference) | 1.0 | ||
| Yes | 4.4 | 2.7-7.3 | < .01 |
| NMSC | |||
| No (reference) | 1.0 | ||
| Yes | 0.1 | 0.04-0.40 | < .01 |
| SMN within sex stratum | |||
| Female no SMN (female reference) | 1.0 | ||
| Female with breast cancer | 0.7 | 0.3-1.6 | .38 |
| Female with non breast cancer SMN | 2.6 | 1.4-5.1 | < .01 |
| Male, no SMN (male reference) | 1.0 | ||
| Male with SMN | 2.3 | 1.4-3.9 | < .01 |
HR indicates hazard ratio; and CI, confidence interval.
Chronic cardiovascular (CV) conditions, nonmelanoma skin cancer (NMSC), and second malignant neoplasms (SMNs) are adjusted as time-dependent covariates. No significant effect of pulmonary or thyroid condition or recurrent HL was observed on overall mortality in univariate or multivariable modeling; hence, they were not included in the final model. SMN effects differed within sex stratum, with differences primarily because of lower risks due to breast cancer. Effects are presented within sex stratum to show this phenomenon. No interaction was observed between sex and chronic cardiac condition. Exposure to anthracycline was expressed as a total score, based on the tertile of cumulative dose received; a score of 0 indicates no exposure to the agent.34
Multiply by 100 to convert gray to rad.