A new case series published in the journal Cardio-Oncology on 17 October 2026 reports the experience of one center in treating lymphoma in five such patients, offering one of the few detailed accounts of how curative chemotherapy can be delivered in this uniquely vulnerable group.
The report, authored by Julian Hirschbaum and colleagues including Gentian Lluri, arrives against a stark backdrop. The authors note that cancer is the fourth leading cause of mortality in adults with congenital heart disease, and that roughly 30,000 people in the United States are living with a Fontan circulation. Despite this growing population, they write, there is a paucity of data on the outcomes of lymphoma treatment among single-ventricle patients with Fontan physiology.
The series comprised five patients with Fontan circulation who developed lymphoma and underwent curative chemotherapy. Two of the patients had Hodgkin lymphoma, while three had large B-cell lymphoma. For each patient, the authors describe the underlying congenital anatomy, including systemic ventricular morphology, the specific type of Fontan operation each had undergone, the clinical presentation of the malignancy, the cancer treatments delivered, and relevant diagnostic data.
At the heart of the report is the pathophysiology of the Fontan state.
The authors’ central conclusion is that treating lymphoma in this population requires vigilance, close monitoring, and multidisciplinary collaboration between cardiologists and oncologists. In the case series, they explain their institutional experience with lymphoma treatment among patients with Fontan circulation, framing the report as a description of practice rather than a comparison of treatment strategies or a demonstration of superior outcomes.
The report is published as an open-access article and is explicitly labeled a case series drawn from a single center, with five patients. That scope is both its strength and its limitation: it provides granular clinical detail that large registry studies often lack, but it cannot establish how representative these five courses of treatment are of the wider Fontan population, and it does not report comparative outcome data.
The authors are direct about the need for more evidence. They state that further studies regarding the treatment of hematologic malignancy in this unique and ever-growing population are needed.
Subject of Research: Management of lymphoma with curative chemotherapy in adult patients with Fontan circulation
Article Title: Single center experience in management of lymphoma among adult patients with Fontan circulation
Article References: Hirschbaum, J., Ghandakly, E., Chai-Ho, W., Yang, E. H., Stein-Merlob, A., & Lluri, G. (2026). Single center experience in management of lymphoma among adult patients with Fontan circulation. Cardio-Oncology. https://doi.org/10.1186/s40959-026-00592-x
Image Credits: AI Generated
DOI: 10.1186/s40959-026-00592-x
Keywords: Fontan circulation, lymphoma, congenital heart disease, case series, cardiotoxicity, chemotherapy, Hodgkin lymphoma, large B-cell lymphoma, cardio-oncology, single ventricle, Single, center
News Source: Nathaniel Bowman. (October 28, 2026). Five Adult Fontan Patients Treated for Lymphoma in Single-Center Case Series. Scienmag.
