Hodgkin's disease and secondary Philadelphia chromosome positive chronic myelogenous leukemia

Bouabdallah, Krimo; Marit, Gérald; Broustet, A; Bilhou-Nabéra, Chrystèle; Wen, Zhongmei; Bernard, Philippe

doi:10.1016/0165-4608(91)90091-8

Cited by 7 publications

(2 citation statements)

References 9 publications

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“…Until now, CML has not been mentioned as an SM in the major adult case collections of second cancers after HD [1,16,31,44,46,48]. One case was reported in a pediatric study (latency 15 years, [5]) and two were case reports (latency 5 and 16 years [10,38]). Both our cases occurred after prolonged follow-up (21 and 27 years after the initial diagnosis of HD, or 10 and 15 years after last treatment for relapse) and can therefore be differentiated from cases of AML which occur in the time frame of 3-10 years after treatment for Hodgkin's disease and have a decreasing risk after a prolonged follow-up time [8].…”

Section: Discussionmentioning

confidence: 91%

Second malignancies after Hodgkin's disease: the Munich experience

Munker¹,

Grützner²,

Hiller³

et al. 1999

Annals of Hematology

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The occurrence of second malignancies (SM) is an important late event following the treatment of Hodgkin's disease (HD). We sought to determine the incidence, the risk factors, and the prognosis of SM in our population of patients with HD. A total of 1120 patients diagnosed with HD were registered at six participating institutions in Munich (calendar period 1974-1994). The mean follow-up for the development of SM was 9.1 years. A cumulative treatment score was calculated for both radio- and chemotherapy. The relative and absolute risks of SM were established. All SM were investigated for response to treatment and outcome. We observed 85 SM [eight leukemias, 22 non-Hodgkin's lymphomas (NHL), two plasma cell neoplasias, and 53 solid tumors]. Five patients developed third malignancies. The relative risk of developing a second neoplasm was compared with that within the normal population and was 3.1-fold. The risk varied according to the category of SM. Higher relative risks (20.5 and 25.9-fold), but lower absolute risks were observed for leukemias and non-Hodgkin's lymphomas. Solid tumors had lower relative risks (1.8-fold). Splenectomy increased the risk of SM (relative risk 4.4-fold versus 2.7-fold). The risk of SM did not correlate with the initial treatment (radio- or chemotherapy) and did not decrease with prolonged follow-up. The cumulative intensity of radiotherapy, chemotherapy, or the two modalities combined correlated with the risk of SM. Since some cases occurred early after diagnosis, not all second neoplasms can be considered treatment-associated. After 15 years, an actuarial risk of 11.7% was calculated for all SM, of 1.0% for leukemias, of 3.0% for NHL, and of 7.7% for solid tumors. The prognosis of SM varied between good (thyroid cancer, melanoma: median survival 5+ years), average (breast cancer, NHL), and poor (acute myeloid leukemias, lung cancers: median survival 9 months). With the exception of NHL, second cancers often occurred in topographic relation to the field of previous radiotherapy. Taken together, in our patient population, we observed all three categories of SM (solid tumors, leukemias, NHL). The risk for second leukemias is lower than in previous studies, whereas the risk of second NHL is somewhat higher. We confirm that splenectomy is a possible risk factor for SM. Even after correction for the age-specific cancer incidence, treatment intensity is associated with the development of second malignant tumors. Continued follow-up is mandatory after treatment for HD. Since the prognosis of most SM is unfavorable, early recognition and prevention are of the utmost importance.

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Section: Discussionmentioning

confidence: 91%

Second malignancies after Hodgkin's disease: the Munich experience

Munker¹,

Grützner²,

Hiller³

et al. 1999

Annals of Hematology

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“…The most common primary cancer observed was HD with ten cases; it was most often treated with MOPP (mechlorethamine, vincristine, procarbazine, prednisone) chemotherapy in combination with RT [12,15,21,37,52,72,91,100,110,124]. Information about radiation doses was limited.…”

Section: The Role Of Irradiation and Radiotherapy In The Development mentioning

confidence: 99%

Treatment-related chronic myelogenous leukemia

Waller

Fetscher

Lange

1999

Annals of Hematology

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Treatment-related (Tr) AML and MDS after chemotherapy, radiotherapy, or the combination of both have been well characterized. However, tr-CML seems to differ from these better-known entities in frequency, clinical course, and prognosis. Tr-CML cannot be distinguished from de novo CML cytogenetically, and, in contrast to tr-AML and tr-MDS, typical chromosomal aberrations related to tr-CML have not been described. Treatment-related CML is a late effect of cytotoxic or immunosuppressive therapy which might be increasingly recognized due to a higher number of patients treated with intensive therapy regimens. We review here the available data on incidence of tr-CML as well as the affected individual's characteristics with regard to different treatment options in malignant and nonmalignant diseases.

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