Risk of subsequent malignant neoplasms among 1,641 Hodgkin's disease patients diagnosed in childhood and adolescence: a population-based cohort study in the five Nordic countries. Association of the Nordic Cancer Registries and the Nordic Society of Pediatric Hematology and Oncology.

1996 ◽  
Vol 14 (5) ◽  
pp. 1442-1446 ◽  
Author(s):  
R Sankila ◽  
S Garwicz ◽  
J H Olsen ◽  
H Döllner ◽  
H Hertz ◽  
...  
Keyword(s):  
Relative Risk ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Cancer Registries ◽  
Incidence Rates ◽  
Nordic Countries ◽  
Malignant Neoplasms ◽  
Childhood And Adolescence ◽  
High Relative Risk ◽  
Secondary Leukemia

PURPOSE To assess the risk of subsequent malignant neoplasms among Hodgkin's disease patients diagnosed before 20 years of age in the five Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden). PATIENTS AND METHODS There were 1,641 Hodgkin's disease patients identified through the national cancer registries since the 1940s or 1950s. The patients were monitored for 17,000 person-years until the end of 1991. Expected figures were derived from the age-specific incidence rates in each country and standardized incidence ratios (SIR) were calculated. RESULTS A total of 62 subsequent neoplasms were diagnosed (SIR, 7.7; 95% confidence interval [CI], 5.9 to 9.9). The overall cumulative risk of subsequent neoplasms was 1.9% at the 10-year follow-up point, 6.9% at 20 years, and 18% at 30 years. There were 26 subsequent neoplasms among males (SIR, 6.5; 95% CI, 4.3 to 9.6) and 36 among females (SIR, 8.9; 95% CI, 6.2 to 12), of which 16 were breast cancers (SIR, 17; 95% CI, 9.9 to 28). High risks were seen for thyroid cancer (SIR, 33; 95% CI, 15 to 62), for secondary leukemia (SIR, 17; 95% CI, 6.9 to 35), and for non-Hodgkin's lymphoma (SIR, 15; 95% CI, 4.9 to 35). The relative risk increased from 3.3 (95% CI, 1.2 to 7.1) for Hodgkin's disease patients diagnosed in the 1940s and 1950s to 15 (95% CI, 7.4 to 27) in the 1980s. The highest risk of secondary leukemia (SIR, 68; 95% CI, 18 to 174) was seen among those diagnosed with Hodgkin's disease in the 1980s. CONCLUSION Patients who survive Hodgkin's disease at a young age are at very high relative risk of subsequent malignant neoplasms throughout their lives. In particular, the high relative risk of breast cancer following Hodgkin's disease in the teenage years calls for enhanced activity for early diagnosis.

Second Malignant Neoplasms Among Long-Term Survivors of Hodgkin’s Disease: A Population-Based Evaluation Over 25 Years

2002 ◽  
Vol 20 (16) ◽  
pp. 3484-3494 ◽  
Author(s):  
Graça M. Dores ◽  
Catherine Metayer ◽  
Rochelle E. Curtis ◽  
Charles F. Lynch ◽  
E. Aileen Clarke ◽  
...  
Keyword(s):  
Relative Risk ◽  
Solid Tumors ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Population Based ◽  
Malignant Neoplasms ◽  
Second Cancers ◽  
Female Breast ◽  
Long Term Survivors

PURPOSE: To quantify the relative and absolute excess risks (AER) of site-specific second cancers, in particular solid tumors, among long-term survivors of Hodgkin’s disease (HD) and to assess risks according to age at HD diagnosis, attained age, and time since initial treatment. PATIENTS AND METHODS: Data from 32,591 HD patients (1,111 25-year survivors) reported to 16 population-based cancer registries in North America and Europe (1935 to 1994) were analyzed. RESULTS: Two thousand one hundred fifty-three second cancers (observed-to-expected ratio [O/E] = 2.3; 95% confidence interval [CI] = 2.2 to 2.4), including 1,726 solid tumors (O/E = 2.0; 95% CI, 1.9 to 2.0) were reported. Cancers of the lung (observed [Obs] = 377; O/E = 2.9), digestive tract (Obs = 376; O/E = 1.7), and female breast (Obs = 234; O/E = 2.0) accounted for the largest number of subsequent malignancies. Twenty-five years after HD diagnosis, the actuarial risk of developing a solid tumor was 21.9%. The relative risk of solid neoplasms decreased with increasing age at HD diagnosis, however, patients aged 51 to 60 years at HD diagnosis sustained the highest cancer burden (AER = 79.2/10,000 patients/year). After a progressive rise in relative risk and AER of all solid tumors over time, there was an apparent downturn in risk at 25 years. Temporal trends and treatment group distribution for cancers of the esophagus, stomach, rectum, female breast, bladder, thyroid, and bone/connective tissue were suggestive of a radiogenic effect. CONCLUSION: Significantly increased risks of second cancers were observed in all HD age groups. Although significantly elevated risks of stomach, female breast, and uterine cervix cancers persisted for 25 years, an apparent decrease in relative risk and AER of solid tumors at other sites is suggested.

scholarly journals Erythrocyte mean corpuscular volume during cytotoxic therapy is a predictive parameter of secondary leukemia in Hodgkin's disease

Cancer ◽  
1987 ◽  
Vol 59 (2) ◽  
pp. 301-304 ◽  
Author(s):  
Aimery De Gramont ◽  
Christophe Louvet ◽  
Marcel Krulik ◽  
Nicole Smadja ◽  
Daniel Donadio ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Mean Corpuscular Volume ◽  
Hodgkin’S Disease ◽  
Corpuscular Volume ◽  
Secondary Leukemia ◽  
Cytotoxic Therapy

scholarly journals Hodgkin's disease (familial) associated with multiple malignant neoplasms

Cancer ◽  
1958 ◽  
Vol 11 (6) ◽  
pp. 1247-1254 ◽  
Author(s):  
Hilliard Cohen ◽  
Sidney Rubin ◽  
Gustave Eisemann
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Malignant Neoplasms

Secondary Leukemia following Treatment for Hodgkin's Disease

1993 ◽  
Vol 79 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Luigi Salvagno ◽  
Lorenzo Simonato ◽  
Mariella Sorarù ◽  
Antonio Bianco ◽  
Vanna Chiarion-Sileni ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Odds Ratio ◽  
Case Control Study ◽  
Hodgkin’S Disease ◽  
Treatment Modalities ◽  
Secondary Leukemia ◽  
Increased Risk ◽  
Radiotherapy Alone ◽  
One Year ◽  
Control Study

Aims and Background Patients treated for Hodgkin's disease with chemotherapy or with the association of chemotherapy and radiotherapy have an increased risk of secondary leukemia. The aim of this study was to evaluate the leukemogenic risk due to these treatment modalities. Methods We performed a case-control study on a population of 1410 patients treated for Hodgkin's disease from 1970 to 1990 in our Institute. Among these patients, we identified 25 cases of secondary leukemia and 3 cases of myelodysplasia, all occurring more than one year after the diagnosis of Hodgkin's disease. Three cases occurred among the patients treated with radiotherapy alone. When we analyzed the risk in relation to the type of treatment (radiotherapy, chemotherapy, or both), the comparisons were relative to patients treated with radiotherapy alone. Results We found that chemotherapy alone is associated with a fivefold increased risk (odds ratio = 5.4) compared with radiotherapy alone. When both treatments are used, the risk is not further increased (odds ratio = 4.4). Patients receiving more than 6 courses of chemotherapy have an excess risk (relative risk = 2.5) compared with those treated with 6 courses or less. No increased risk was observed after splenectomy. Conclusions This study confirms an increased incidence of secondary leukemia occurring in patients treated for Hodgkin's disease. The increased risk seems to be correlated with the number of courses of alkylating agent therapy, whereas it is unaffected by the addition of radiotherapy.

MOPP/ABV hybrid chemotherapy for advanced Hodgkin's disease significantly improves failure-free and overall survival: the 8-year results of the intergroup trial.

1998 ◽  
Vol 16 (1) ◽  
pp. 19-26 ◽  
Author(s):  
J H Glick ◽  
M L Young ◽  
D Harrington ◽  
R L Schilsky ◽  
T Beck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Relative Risk ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Myelogenous Leukemia ◽  
Life Threatening ◽  
Acute Myelogenous ◽  
First Relapse ◽  
Sequential Regimen

PURPOSE To compare the efficacy of sequential mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) followed by doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) versus the MOPP/ABV hybrid regimen in advanced-stage Hodgkin's disease. PATIENTS AND METHODS A total of 737 patients with previously untreated stages III2A, IIIB, IVA, or IVB Hodgkin's disease and patients in first relapse after radiotherapy were prospectively randomized to sequential MOPP-ABV or MOPP/ABV hybrid. Of 691 eligible patients, 344 received the sequential regimen and 347 received the hybrid. RESULTS The overall response rate was 95%, with complete responses (CRs) in 79%: 83% on the MOPP/ABV hybrid and 75% on the sequential MOPP-ABVD arm (P = .02). With a median follow-up time of 7.3 years, the 8-year failure-free survival (FFS) rates were 64% for MOPP/ABV hybrid and 54% far sequential MOPP-ABVD (P = .01; 0.69 relative risk of failure, comparing MOPP/ABV hybrid v MOPP-ABVD). The 8-year overall survival rate was significantly better for the MOPP/ABV hybrid (79%) as compared with sequential MOPP-ABVD (71%) (P = .02; relative risk, 0.65). MOPP/ABV hybrid had significantly more life-threatening or fatal neutropenia and pulmonary toxicity than the sequential MOPP-ABVD arm, which was associated with significantly greater thrombocytopenia. Nine cases of acute myelogenous leukemia or myelodysplasia were reported on the sequential regimen as compared with only one on the hybrid (P = .01). CONCLUSION MOPP/ABV hybrid chemotherapy was significantly more effective than sequential MOPP-ABVD. FFS and overall survival were significantly improved on the hybrid arm, which was also associated with a lower incidence of acute leukemia or myelodysplasia.

Stanford V and Radiotherapy for Locally Extensive and Advanced Hodgkin’s Disease: Mature Results of a Prospective Clinical Trial

2002 ◽  
Vol 20 (3) ◽  
pp. 630-637 ◽  
Author(s):  
Sandra J. Horning ◽  
Richard T. Hoppe ◽  
Sheila Breslin ◽  
Nancy L. Bartlett ◽  
B. William Brown ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Chemotherapy Regimen ◽  
Hodgkin’S Disease ◽  
Prognostic Score ◽  
Secondary Leukemia ◽  
Bulky Disease ◽  
Standard Doxorubicin ◽  
Splenic Disease ◽  
Advanced Hodgkin’S Disease

PURPOSE: To provide more mature data on the efficacy and complications of a brief, dose-intense chemotherapy regimen plus radiation therapy (RT) to bulky disease sites for locally extensive and advanced-stage Hodgkin’s disease. PATIENTS AND METHODS: One hundred forty-two patients with stage III or IV or locally extensive mediastinal stage I or II Hodgkin’s disease received Stanford V chemotherapy for 12 weeks followed by 36-Gy RT to initial sites of bulky (≥ 5 cm) or macroscopic splenic disease. Freedom from progression (FFP), overall survival (OS), and freedom from second relapse (FF2R) were determined using life-table estimates. Outcomes were analyzed according to the international prognostic score. Late effects of treatment were recorded in follow-up. RESULTS: With a median follow-up of 5.4 years, the 5-year FFP was 89% and the OS was 96%. No patient progressed during treatment, and there were no treatment-related deaths. FFP was significantly superior among patients with a prognostic score of 0 to 2 compared with those with a score of 3 and higher (94% v 75%, P < .0001). No secondary leukemia was observed. To date, there have been 42 pregnancies after treatment. Among 16 patients who relapsed, the FF2R was 69% at 5 years. CONCLUSION: These data confirm our preliminary report that Stanford V chemotherapy with RT to bulky disease sites is highly effective in locally extensive and advanced Hodgkin’s disease. It is most important to compare this approach with standard doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy in the ongoing intergroup trial (E2496) to determine whether Stanford V with or without RT represents a therapeutic advance.

Second malignant neoplasms in patients with Hodgkin's disease

1993 ◽  
Vol 29 ◽  
pp. S169
Author(s):  
D. Clark ◽  
P. Rubin ◽  
L. Constine ◽  
D. Nelson ◽  
A. Muhs
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Malignant Neoplasms ◽  
Second Malignant Neoplasms
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