Study: Survivors of Hodgkin Lymphoma Show Signs of Dementia in Early Adulthood

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Participants who survived Hodgkin lymphoma as children showed signs of being biologically older than their peers, with a heightened risk of cognitive problems.

New research has found that the majority of individuals treated as children for Hodgkin lymphoma who are now in their 30s showed signs of being an average of 7.7 years older biologically than their peers. This includes a heightened risk for cognitive problems.

According to the study results, accelerated aging in a group of 215 survivors tended to impact memory most often, and was consistent with very early signs of dementia. The findings were showcased at the American Society of Hematology (ASH) 2022 annual meeting.

Although the researchers are still investigating ways to intervene in this accelerated aging, they suggest that enhanced health screenings and a healthy lifestyle are the best strategies to manage faster aging.

“These survivors have already had 1 hit from treatment, so you want to minimize damage going forward,” said investigator AnnaLynn Williams, PhD, in a press release. “Try to be active, quit smoking, eat healthy, see your primary care physician to get proper testing, and exercise your brain.”

Williams noted that this is the first study investigating why long-term survivors of Hodgkin lymphoma experience cognitive symptoms. Most previous studies have focused on risks for other premature health conditions, such as heart disease. One potential cause for the cognitive decline in the Hodgkin lymphoma cohort could be the childhood treatment with high doses of anthracycline-based chemotherapy and radiation, rather than the cancer itself.

In the study, volunteers agreed to give blood samples and undergo comprehensive and well-validated neurocognitive testing. The Hodgkin lymphoma survivors’ blood samples were analyzed for DNA methylation, which is a marker of changes in DNA expression over time. During that process, the research team found that more than 80% of the survivors experienced epigenetic age acceleration, compared to only 20% of the control group.

“Specifically, we saw strong and consistent associations with memory impairment, which suggests that biologic aging is likely related to cognitive aging,” Williams said in the press release.

The phenomenon of epigenetic age acceleration may turn out to be a useful biomarker to improve life for survivors, according to the investigators. The 7.7 years cited in the study is the average age difference between the Hodgkin lymphoma survivors’ cohort and the control group.

The degree of cognitive impairment seen in these survivors may not be apparent to family and friends, but the survivors themselves may notice things like small lapses in memory. The test results were all clinically meaningful and had the potential to prompt a survivor to feel self-conscious. The Hodgkin lymphoma survivors also self-reported problems with executive function, which is the ability to multitask.

Although modern treatments for childhood Hodgkin lymphoma are somewhat different from those used in the past, it is unclear if current patients will experience similar cognitive decline. Research on this issue is ongoing.

“I hope this study brings attention to the fact that accelerated biological age is not just associated with heart conditions and such, but that it may also include poor cognitive function,” Williams said in the press release. “We need more awareness that our Hodgkin lymphoma survivors may be struggling with this.”

REFERENCE

Study: Hodgkin lymphoma survivors show signs of dementia in early adulthood. News release. EurekAlert; December 13, 2022. Accessed December 21, 2022. https://www.eurekalert.org/news-releases/974366

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