Acute Myeloid Leukemia Following Hodgkin Lymphoma: A Population-Based Study of 35 511 Patients

University of Toronto, Toronto, Ontario, Canada
Journal of the National Cancer Institute (Impact Factor: 12.58). 02/2006; 98(3):215-8. DOI: 10.1093/jnci/djj017
Source: PubMed


Treatments for Hodgkin lymphoma are associated with large relative risks of acute myeloid leukemia (AML), but there are few estimates of the excess absolute risk (EAR), a useful measure of disease burden. One-year Hodgkin lymphoma survivors (N = 35,511) were identified within 14 population-based cancer registries in Nordic countries and North America from January 1, 1970, through December 31, 2001. We used Poisson regression analysis to model the EAR of AML, per 10,000 person-years. A total of 217 Hodgkin lymphoma survivors were diagnosed with AML (10.8 expected; unadjusted EAR = 6.2; 95% confidence interval = 5.4 to 7.1). Excess absolute risk for AML was highest during the first 10 years after Hodgkin lymphoma diagnosis but remained elevated thereafter. In subsequent analyses, adjusted for time since Hodgkin lymphoma diagnosis and presented for the 5-9 year interval, the EAR was statistically significantly (P < .001) larger in patients diagnosed with Hodgkin lymphoma at age 35 years and older than in those diagnosed before 35 years of age. The EAR of AML declined statistically significantly after 1984 (7.0 to 4.2 and 16.4 to 9.9 in the < 35 and > or = 35 age groups, respectively), which may be associated with modifications in chemotherapy.

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Available from: Michael Andersson, Sep 30, 2015
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    • "Indeed, it was in part the leukemogenicity of the older MOPP regimen that helped fuel the ascendance of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) as the chemotherapeutic standard of care for average-risk HL. The absolute excess risk of AML following treatment with ABVD is between 0 and 0.4%, whereas with MOPP was 2.8% (and with MOPP and radiotherapy as CMT, 5.5%).[25] [30] [31] The modern intensified regimen, escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and is associated with a risk of AML of 3.2%. "

    Full-text · Chapter · Feb 2012
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    • "In a review of cancer registries in a number of countries from 1970 to 2001, Schonfeld et al. noted that the incidence of acute myelogenous leukemia in patient with HL has declined. They propose that this change is probably related to change in chemotherapy [8] "
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    ABSTRACT: The presentation of Hodgkin Lymphoma in a thymic cyst is rare. We describe a case in a 9 year-old boy, with a long follow-up course, complicated by two secondary neoplasms and a post bone marrow transplant lymphoproliferative disorder. We also review the literature on such presentations and second malignant neoplasms in childhood.
    Full-text · Article · Jun 2010 · Case Reports in Medicine
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    • "Second malignancies remain a significant risk factor post - treatment , especially within the adolescent age group . Survi - vors of HL have been consistently shown to have increased risk of developing NHL , leukaemia , gastrointestinal cancers , mel - anoma , thyroid cancer and breast cancer ( van Leeuwen et al , 1994a , b ; Boivin et al , 1995 ; Wolden et al , 1998 ; Bhatia et al , 2003 ; Josting et al , 2003 ; Schonfeld et al , 2006 ) . The data suggests that children and adolescents are at higher risk of development of these cancers than adult survivors . "
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    ABSTRACT: Lymphoma is the most common malignancy among adolescents, accounting for >25% of newly diagnosed cancers in the 15-19 year age group. Hodgkin lymphoma (HL) accounts for the majority (two-thirds) of cases, while the remainder of patients have one of four subtypes of non-Hodgkin lymphoma (NHL): diffuse large B-cell lymphoma (DLBCL) including primary mediastinal B-cell lymphoma (PMBL), Burkitt lymphoma (BL), lymphoblastic lymphoma (LL) or anaplastic large cell lymphoma (ALCL). Epidemiology, histology, treatment and outcome differ between HL and NHL, as well as among the various subtypes of NHL. Adolescent lymphoma is particularly interesting because it often shares features with both childhood and adult lymphoma. As medical oncologists and paediatric oncologists often follow divergent treatment plans, disagreements may arise between practitioners as to how best treat the adolescent group. Additional complicating factors associated with the adolescent years, such as lack of insurance, issues pertaining to body image, and concerns about fertility, can also hinder prompt, appropriate medical management. This review details the complexities associated with the diagnosis and treatment of adolescent lymphoma and updates the state of the science, with particular emphasis on epidemiology, diagnosis, and proper management of HL and the various subtypes of NHL.
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