This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Radiation Therapy  • Leukemias/ Lymphomas  • Hepatobiliary Surgery  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 72 words of the full text and any section headings.

To the Editor: Dr Hull and colleagues¹ found that radiation therapy was associated with an increased incidence of atherosclerotic events among patients with Hodgkin lymphoma. Many of these patients, however, were treated during a time when splenectomy was a common part of staging for Hodgkin disease. Splenectomy is a risk factor for myocardial infarction^2-4 and other atherosclerotic events.³ I believe that the authors should have accounted for splenectomy status in their analysis.

Robert F. Schilling, MD
rfsmd@medicine.wisc.edu
Department of Medicine
University of Wisconsin
Madison

1. Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treated with radiation therapy. JAMA. 2003;290:2831-2837. FREE FULL TEXT 2. Robinette CD, Fraumeni JF Jr. Splenectomy and subsequent mortality in veterans of the 1939-45 war. Lancet. 1977;2:127-129. PUBMED 3. Schilling RF. Spherocytosis, splenectomy, strokes, and heart attacks. Lancet. 1997;350:1677-1678. PUBMED 4. Scholz KH, Hermann C, Tebbe U, Chemnitius JM, Helmchen U, Kreuzer H. Myocardial infarction in young patients with Hodgkin's disease-potential pathogenic role of radiotherapy, chemotherapy, and splenectomy. Clin Invest. 1993;71:57-64. PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:433-434.

RELATED ARTICLES

Radiation Therapy and Risk of Cardiovascular Disease
Gabor Gyenes and George Gyenes
JAMA. 2004;292(4):434.
EXTRACT | FULL TEXT  

Radiation Therapy and Risk of Cardiovascular Disease—Reply
Nancy Price Mendenhall
JAMA. 2004;292(4):434.
EXTRACT | FULL TEXT  

Valvular Dysfunction and Carotid, Subclavian, and Coronary Artery Disease in Survivors of Hodgkin Lymphoma Treated With Radiation Therapy
Matthew C. Hull, Christopher G. Morris, Carl J. Pepine, and Nancy Price Mendenhall
JAMA. 2003;290(21):2831-2837.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Be physically active: the best buy in promoting heart health
De Backer and Bacquer
Eur Heart J 2004;25:2183-2184.
FULL TEXT