Long-term risk of second malignancy after treatment of Hodgkin’s disease: the influence of treatment, age andfollow-up time

Abrahamsen, Arne Foss; Andersen, Aage; Nome, Ole; Jacobsen, A. B.; Holte, Harald; Abrahamsen, Jenny Foss; Kvaløy, Stein

doi:10.1093/annonc/mdf289

Cited by 104 publications

(70 citation statements)

References 21 publications

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“…4,7,[11][12][13][14] A protective effect of breastfeeding on the risk of premenopausal breast cancer has been observed in several studies, although not in all analyses. [31][32][33][34][35][36][37] Although the small size of this cohort prohibits analysis of the possibility that lactation might be protective, further studies in larger survivor cohorts may be indicated.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding in survivors of Hodgkin lymphoma treated with chest radiotherapy

McCullough

Najita

et al. 2010

Cancer

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BACKGROUND: Female survivors of therapeutic chest radiation often question whether they will have difficulty with breast feeding, given their prior exposure to breast radiation. In the current study, the rates of successful breastfeeding in long-term survivors who received chest radiotherapy (CXRT) as a treatment for Hodgkin lymphoma (HL) were examined. METHODS: A survey study of survivors of HL who were treated at the Joint Center for Radiation Therapy in Boston from 1969 through 1996 was performed. Patients were queried about childbearing and breastfeeding. The authors analyzed self-reported breastfeeding success in women who reported live births after CXRT and compared them with a sibling control group. RESULTS: Overall, 83 female survivors of HL who were treated with CXRT reported at least 1 birth after treatment. There were a total of 141 post-HL pregnancies resulting in births. In these women, the median age at the time of the HL diagnosis was 23 years (range, 14-40 years) and the median radiation dose was 41 grays (Gy) (range, 27-46 Gy). For survivors, 57 of the 94 (61%) breastfeeding attempts were successful, whereas within the control group, 74 of the 94 (79%) attempts were successful (P ¼.044). Accounting for maternal age at first birth and birth era, multivariable analysis suggested that HL survivors treated with CXRT may be less likely to breastfeed successfully than their siblings (odds ratio, 0.42; 95% confidence interval, 0.2-1.0 [P ¼.06]). CONCLUSIONS: The majority of female HL survivors who were treated with CXRT report being able to breastfeed successfully. However, the results of the current study indicate a trend toward less successful breastfeeding in survivors as a previously unreported late effect of radiation. Cancer 2010;116:4866-71.

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Section: Discussionmentioning

confidence: 99%

Breastfeeding in survivors of Hodgkin lymphoma treated with chest radiotherapy

McCullough

Najita

et al. 2010

Cancer

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“…The reason for the latter observation is unclear. Although rituximab has been associated with increased long-term risk of solid malignancies in patients with lymphoma (32), this association has not been shown in the rheumatoid arthritis population (26,33). Patients should be educated about these risks when choosing between treatment regimens.…”

Section: Malignanciesmentioning

confidence: 99%

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Hogan

Avasare

2014

Clinical Journal of the American Society of Nephrology

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Clinical outcomes in ANCA-associated vasculitis (AAV) and lupus nephritis have improved greatly with treatment regimens containing high-dose glucocorticoids and cyclophosphamide. However, with the use of these medications come significant adverse events, most notably infections, cytopenias, malignancies, and reproductive abnormalities. Multiple recent randomized controlled trials in AAV and lupus nephritis have compared cyclophosphamide-based regimens with agents such as rituximab, mycophenolate mofetil, and azathioprine, with the hope of providing better clinical outcomes with improved safety profiles. Although some of these newer regimens are now considered first-line treatments of these diseases, their adverse event profiles have been disappointingly similar to those of cyclophosphamide-based protocols. Physicians and patients should consider the adverse event profiles generated by these trials in the context of their extensive use in other patient populations, as well as available measures to prevent such events, when choosing the ideal regimen for an individual patient.

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“…Radiation therapy also has been associated with increased melanoma development, as seen in a study of patients with Hodgkin lymphoma. 88 In this cohort, the incidence ratio of both melanoma and NHL increased significantly and melanoma risk remained increased for more than 20 years, with most tumors forming within or at the boundaries of the irradiated field. Similar observations have been made in the breast cancer literature, with studies noting increased risk of melanoma in patients with breast cancer and in those treated with irradiation.…”

Section: Clinical Course Of Melanoma In Lymphoma Patientsmentioning

confidence: 68%

Melanoma in Immunosuppressed Patients

Kubica

Brewer

2012

Mayo Clinic Proceedings

110

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The immunogenic characteristics of malignant melanoma are intriguing. To date, multiple studies exist regarding the immunogenicity of melanoma. In this article, we summarize data in the literature on the role of immunosuppression in melanoma and discuss several immunocompromised patient populations in detail. A comprehensive PubMed search was conducted with no date limitation. The following search terms were used: melanoma in combination with immunosuppression, immunocompromised, genetics, antigen processing, UV radiation, organ transplantation, organ transplant recipients, lymphoproliferative disease, lymphoma, CLL, NHL, radiation, and HIV/AIDS. Although no formal criteria were used for inclusion of studies, most pertinent studies on the topic were reviewed, with the exception of smaller case reports and case series. The included studies were generally large (Ն1000 patients in organ transplant recipient studies; Ն500 patients in lymphoma studies), with a focus on institutional experiences, or population-based national or international epidemiologic studies. Melanoma-induced immunosuppression, the role of UV radiation in melanoma development, and the epidemiology, clinical course, and prognosis of melanoma in immunocompromised patients are highlighted. Organ transplant recipients, patients with lymphoproliferative disorders, patients with iatrogenic immunosuppression, and patients with human immunodeficiency virus infection/AIDS are also highlighted. Recommendations are proposed for the care and monitoring of immunosuppressed patients with melanoma. With better understanding of the molecular microenvironment and clinical course of melanoma in immunosuppressed patients, novel therapies could be developed and outcomes potentially affected in these patients.

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Long-term risk of second malignancy after treatment of Hodgkin’s disease: the influence of treatment, age andfollow-up time

Cited by 104 publications

References 21 publications

Breastfeeding in survivors of Hodgkin lymphoma treated with chest radiotherapy

Breastfeeding in survivors of Hodgkin lymphoma treated with chest radiotherapy

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Melanoma in Immunosuppressed Patients

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