APNEA: Sleep Apnea in Hodgkin Lymphoma Survivors Treated with Radiation to the Chest

Brief Summary

While thoracic radiation therapy has been a primary component in successful treatment of Hodgkin lymphoma, exposure to this treatment has been associated with significant cardiovascular, cerebrovascular and pulmonary morbidity in long-term survivors. Survivors of Hodgkin lymphoma are also at risk for fatigue and excessive daytime sleepiness. In a small pilot study of 30 long-term survivors of Hodgkin lymphoma, St. Jude researchers determined 14 (47%) met clinical criteria for obstructive sleep apnea, which has been independently linked to other serious health problems. Survivors of Hodgkin lymphoma, who are already at risk for cardiac and neurologic morbidity due to their treatment exposures, could face catastrophic cardiovascular and cerebrovascular events with the added risk associated with obstructive sleep apnea.

Long-term survivors in the St. Jude LIFE study who received thoracic radiation therapy for Hodgkin lymphoma when they were children or teenagers will take part in this study. Researchers will examine indices of sleep quality using polysomnography, and associated neurocognitive performance, brain MRI, and structure and strength of neck muscles. A comparison group composed of non-patient volunteers will complete the polysomnography, neurocognitive evaluation and select other tests at St. Jude or remotely.

Primary Objectives

• To estimate the prevalence of obstructive sleep apnea in adult survivors of Hodgkin lymphoma treated with thoracic radiation therapy, and compare the frequency to community controls matched on age, sex, race and body mass index
• To identify specific therapeutic factors associated with obstructive sleep apnea in these survivors
• To identify biomarkers of obstructive sleep apnea in these survivors
• To examine associations between obstructive sleep apnea and cardiac morbidity and brain integrity in these survivors

Eligibility Criteria

Inclusion criteria include:

Hodgkin lymphoma survivor

• Patient eligible for the St. Jude LIFE study
• Treated with thoracic radiation for Hodgkin lymphoma
• At least 18 years old
• At least 5 years from original diagnosis
• If participating remotely, must have Wi-Fi access

Comparison group

• Non-patient volunteer (Cannot be a sibling, parent or child of the survivor participant)
• At least 18 years old
• Lives in the U.S.
• If participating remotely, must have Wi-Fi access

Exclusion Criteria include:

Hodgkin lymphoma survivor

• History of cranial or total-body radiation therapy
• History of intrathecal methotrexate, high-dose methotrexate or high-dose cytarabine
• History of head injury or diagnosis of a genetic disorder associated with neurocognitive impairment
• Pregnant

Comparison group

• History of cranial or total-body radiation therapy
• History of intrathecal methotrexate, high-dose methotrexate or high-dose cytarabine
• History of head injury or diagnosis of a genetic disorder associated with neurocognitive impairment
• Pregnant
• History of cancer
• First-degree relative of a survivor in the APNEA study

Study Design

Observational, case-control, prospective

Study Sites

St. Jude Children’s Research Hospital
Memphis, Tennessee

About this study

Some patients who receive radiation therapy for cancer develop long-term side effects. These may include damage to the heart and lungs, poor sleep quality and a disorder known as obstructive sleep apnea. People who have this disorder have long pauses in their breathing while they sleep.

This clinical trial will look at sleep problems in adult survivors of Hodgkin lymphoma who were treated with chest radiation at St. Jude Children’s Research Hospital when they were children or teenagers. SJ LIFE study participants will take part in an overnight sleep study and have other tests to measure heart, lung and brain functions. Researchers will compare the test results of survivors to a separate group of adults who were not treated for cancer.

Purpose of this clinical trial

The main goal of this study is to see how common sleep problems are in adults who were treated for Hodgkin lymphoma as children or teenagers. Researchers also want to find out if cancer treatments given to the heart and lungs are connected to obstructive sleep apnea in adult survivors.

Eligibility overview

Hodgkin lymphoma survivor

• Patient eligible for the St. Jude LIFE  study
• Thoracic radiation for Hodgkin lymphoma
• At least 18 years old
• At least 5 years from original diagnosis
• If participating remotely, must have Wi-Fi access

Comparison group

• Non-patient volunteer (Cannot be a sibling, parent or child of the survivor participant)
• At least 18 years old
• Lives in the U.S.
• If participating remotely, must have Wi-Fi access