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. 1993 Nov;68(5):1006–1011. doi: 10.1038/bjc.1993.470

Risk of second primary cancer after Hodgkin's disease in patients in the British National Lymphoma Investigation: relationships to host factors, histology and stage of Hodgkin's disease, and splenectomy.

A J Swerdlow 1, A J Douglas 1, G Vaughan Hudson 1, B Vaughan Hudson 1, K A MacLennan 1
PMCID: PMC1968752  PMID: 8217588

Abstract

The risks of second primary cancer were analysed in 2846 patients with Hodgkin's disease treated within the British National Lymphoma Investigation during 1970-87. The relative risk (RR) of leukaemia was significantly greater in women (RR = 30.1; 95% confidence limits (CL) 13.0-59.5) than in men (RR = 10.9; 95% CL 4.7-21.5), and showed a significant trend of greater risk with younger age at first treatment (P < 0.001). The relative risk of solid cancers was similar between the sexes, but again significantly greater at young than at older ages of first treatment (P < 0.01). Non-Hodgkin's lymphoma relative risks, although not related to sex or age, were significantly related to histology of the original Hodgkin's disease, and were greatest after lymphocyte predominant Hodgkin's disease (RR = 55.6; 95% CL 18.0-129.7). The relative risk of second cancers did not vary significantly according to whether or not splenectomy had been performed. Leukaemia risk was non-significantly greater after splenectomy than with no splenectomy, which accorded with previous evidence of a modest increased risk associated with this operation. If the greater relative risk of solid second cancers after treatment at young than at older ages persists with longer follow-up, the incidence rates of these second primaries in patients treated young for Hodgkin's disease will become very substantial as they age. This emphasises the need to maintain long-term follow-up surveillance of young Hodgkin's disease patients apparently cured of their disease, and to continue to develop new less carcinogenic treatment regimens.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bennett M. H., MacLennan K. A., Vaughan Hudson G., Vaughan Hudson B. Non-Hodgkin's lymphoma arising in patients treated for Hodgkin's disease in the BNLI: a 20-year experience. British National Lymphoma Investigation. Ann Oncol. 1991 Feb;2 (Suppl 2):83–92. doi: 10.1093/annonc/2.suppl_2.83. [DOI] [PubMed] [Google Scholar]
  2. Boivin J. F., Hutchison G. B., Lyden M., Godbold J., Chorosh J., Schottenfeld D. Second primary cancers following treatment of Hodgkin's disease. J Natl Cancer Inst. 1984 Feb;72(2):233–241. [PubMed] [Google Scholar]
  3. Boivin J. F., O'Brien K. Solid cancer risk after treatment of Hodgkin's disease. Cancer. 1988 Jun 15;61(12):2541–2546. doi: 10.1002/1097-0142(19880615)61:12<2541::aid-cncr2820611225>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  4. Carbone P. P., Kaplan H. S., Musshoff K., Smithers D. W., Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971 Nov;31(11):1860–1861. [PubMed] [Google Scholar]
  5. Coleman M., Douglas A., Hermon C., Peto J. Cohort study analysis with a FORTRAN computer program. Int J Epidemiol. 1986 Mar;15(1):134–137. doi: 10.1093/ije/15.1.134. [DOI] [PubMed] [Google Scholar]
  6. Colman M., Easton D. F., Horwich A., Peckham M. J. Second malignancies and Hodgkin's disease--the Royal Marsden Hospital experience. Radiother Oncol. 1988 Mar;11(3):229–238. doi: 10.1016/0167-8140(88)90005-9. [DOI] [PubMed] [Google Scholar]
  7. Hansmann M. L., Stein H., Fellbaum C., Hui P. K., Parwaresch M. R., Lennert K. Nodular paragranuloma can transform into high-grade malignant lymphoma of B type. Hum Pathol. 1989 Dec;20(12):1169–1175. doi: 10.1016/s0046-8177(89)80007-3. [DOI] [PubMed] [Google Scholar]
  8. Henry-Amar M. Quantitative risk of second cancer in patients in first complete remission from early stages of Hodgkin's disease. NCI Monogr. 1988;(6):65–72. [PubMed] [Google Scholar]
  9. Kaldor J. M., Day N. E., Band P., Choi N. W., Clarke E. A., Coleman M. P., Hakama M., Koch M., Langmark F., Neal F. E. Second malignancies following testicular cancer, ovarian cancer and Hodgkin's disease: an international collaborative study among cancer registries. Int J Cancer. 1987 May 15;39(5):571–585. doi: 10.1002/ijc.2910390506. [DOI] [PubMed] [Google Scholar]
  10. Kaldor J. M., Day N. E., Clarke E. A., Van Leeuwen F. E., Henry-Amar M., Fiorentino M. V., Bell J., Pedersen D., Band P., Assouline D. Leukemia following Hodgkin's disease. N Engl J Med. 1990 Jan 4;322(1):7–13. doi: 10.1056/NEJM199001043220102. [DOI] [PubMed] [Google Scholar]
  11. Miettinen M., Franssila K. O., Saxén E. Hodgkin's disease, lymphocytic predominance nodular. Increased risk for subsequent non-Hodgkin's lymphomas. Cancer. 1983 Jun 15;51(12):2293–2300. doi: 10.1002/1097-0142(19830615)51:12<2293::aid-cncr2820511221>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  12. Pedersen-Bjergaard J., Specht L., Larsen S. O., Ersbøll J., Struck J., Hansen M. M., Hansen H. H., Nissen N. I. Risk of therapy-related leukaemia and preleukaemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy. Lancet. 1987 Jul 11;2(8550):83–88. doi: 10.1016/s0140-6736(87)92744-9. [DOI] [PubMed] [Google Scholar]
  13. Sundeen J. T., Cossman J., Jaffe E. S. Lymphocyte predominant Hodgkin's disease nodular subtype with coexistent "large cell lymphoma". Histological progression or composite malignancy? Am J Surg Pathol. 1988 Aug;12(8):599–606. [PubMed] [Google Scholar]
  14. Swerdlow A. J., Douglas A. J., Hudson G. V., Hudson B. V., Bennett M. H., MacLennan K. A. Risk of second primary cancers after Hodgkin's disease by type of treatment: analysis of 2846 patients in the British National Lymphoma Investigation. BMJ. 1992 May 2;304(6835):1137–1143. doi: 10.1136/bmj.304.6835.1137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Tester W. J., Kinsella T. J., Waller B., Makuch R. W., Kelley P. A., Glatstein E., DeVita V. T. Second malignant neoplasms complicating Hodgkin's disease: the National Cancer Institute experience. J Clin Oncol. 1984 Jul;2(7):762–769. doi: 10.1200/JCO.1984.2.7.762. [DOI] [PubMed] [Google Scholar]
  16. Tucker M. A., Coleman C. N., Cox R. S., Varghese A., Rosenberg S. A. Risk of second cancers after treatment for Hodgkin's disease. N Engl J Med. 1988 Jan 14;318(2):76–81. doi: 10.1056/NEJM198801143180203. [DOI] [PubMed] [Google Scholar]
  17. Valagussa P., Santoro A., Fossati-Bellani F., Banfi A., Bonadonna G. Second acute leukemia and other malignancies following treatment for Hodgkin's disease. J Clin Oncol. 1986 Jun;4(6):830–837. doi: 10.1200/JCO.1986.4.6.830. [DOI] [PubMed] [Google Scholar]
  18. van Leeuwen F. E., Somers R., Taal B. G., van Heerde P., Coster B., Dozeman T., Huisman S. J., Hart A. A. Increased risk of lung cancer, non-Hodgkin's lymphoma, and leukemia following Hodgkin's disease. J Clin Oncol. 1989 Aug;7(8):1046–1058. doi: 10.1200/JCO.1989.7.8.1046. [DOI] [PubMed] [Google Scholar]
  19. van der Velden J. W., van Putten W. L., Guinee V. F., Pfeiffer R., van Leeuwen F. E., van der Linden E. A., Vardomskaya I., Lane W., Durand M., Lagarde C. Subsequent development of acute non-lymphocytic leukemia in patients treated for Hodgkin's disease. Int J Cancer. 1988 Aug 15;42(2):252–255. doi: 10.1002/ijc.2910420218. [DOI] [PubMed] [Google Scholar]

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