Published online 11 February 2008
Haematologica, Vol 93, Issue 3, 398-404 doi:10.3324/haematol.12120
Copyright © 2008 by Ferrata Storti Foundation
Stefano Sacchi1, ,
Luigi Marcheselli1 ,
Alessia Bari1 ,
Raffaella Marcheselli1 ,
Samantha Pozzi1 ,
Stefano Luminari1 ,
Marco Lombardo2 ,
Gabriele Buda3 ,
Antonio Lazzaro4 ,
Paolo G. Gobbi5 ,
Caterina Stelitano6 ,
Fortunato Morabito7 ,
Giovanni Quarta8 ,
Maura Brugiatelli9
Haematologica, Vol 93, Issue 3, 398-404 doi:10.3324/haematol.12120
Copyright © 2008 by Ferrata Storti Foundation
Malignant Lymphomas |
Secondary malignancies after treatment for indolent non-Hodgkin’s lymphoma: a 16-year follow-up study
1 Dipartimento di Oncologia ed Ematologia Università di Modena Centro Oncologico Modenese, Policlinico Modena
2 Dipartimento di Oncologia, Ospedale Santo Spirito, Pescara
3 Dipartimento di Oncologia, Sezione Ematologia, Ospedale Santa Chiara, Pisa
4 Medicina Oncologica ed Ematologica, Ospedale Civile, Piacenza
5 Clinica Medica, IRCCS Policlinico San Matteo, Università di Pavia, Pavia
6 Divisione di Ematologia, Presidio Ospedali Riuniti Bianchi, Melacrino, Morelli, Reggio Calabria
7 Unità Operativa di Ematologia, Azienda Ospedaliera dell’Annunziata, Cosenza
8 Divisione di Ematologia, Presidio Ospedaliero A. Perrino, Brindisi
9 Divisione di Ematologia, Azienda Ospedaliera Papardo, Messina, Italy
Correspondence: Stefano Sacchi, MD Dipartimento di Oncologia ed Ematologia, Università di Modena Centro Oncologico Modenese Policlinico, 41100 Modena, Italy. E-mail: ssacchi{at}unimo.it
Background: Relatively little information is available on the incidence of secondary cancer in non-Hodgkin’s lymphoma. The aim of this long-term follow-up study was to determine the incidence, the time free of second tumors, and risk factors for developing secondary cancer in a homogeneous group of patients with non-Hodgkin’s lymphoma.
Design and Methods: We evaluated a total of 563 patients with indolent non-Hodgkin’s lymphoma enrolled in Gruppo Italiano Studio Linfomi trials from 1988 to 2003.
Results: After a median follow-up of 62 months, 39 patients (6.9%) developed secondary cancer: 12 myelodysplastic syndromes/acute myeloid leukemia, and 27 solid tumors. The overall standardized incidence ratio of secondary malignancy in patients with non-Hodgkin’s lymphoma was higher than the risk of malignancy in the general population. The standardized incidence ratio was elevated in male patients and in patients under 65 years old at first treatment. Overall, the cumulative incidence of secondary cancer at 12 years was 10.5%, after correction in a competing-risk model. Univariate and multivariate Cox regression analyses showed that older age at the time of diagnosis, male sex, and fludarabine-containing therapy had significant negative impacts on the time free of second tumors.
Conclusions: We have identified subgroups of non-Hodgkin’s lymphoma patients with increased standardized incidence ratios of secondary malignancy and variables that have a negative impact on the time free of second tumors. This information could help physicians to select the most appropriate treatments. Finally, taking into account the possible occurrence of secondary neoplasia, long-term monitoring must be considered.
Key words: second cancer, non-Hodgkin lymphoma, follicular lymphoma, small lymphocytic lymphoma, treatment.
Related Articles
Haematologica 2008 93: e57.
Haematologica 2008 93: e58.
Haematologica 2008 93: 336-338.
This article has been cited by other articles:
 |
|
 |
|
  C. Gisselbrecht, J. Vose, A. Nademanee, A. M. Gianni, and A. Nagler Radioimmunotherapy for Stem Cell Transplantation in Non-Hodgkin's Lymphoma: In Pursuit of a Complete Response Oncologist, October 1, 2009; 14(suppl_2): 41 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Foster, D. A. Gabriel, and T. Shea Role of Hematopoietic Stem Cell Transplant in the Management of Follicular Lymphoma Oncologist, July 1, 2009; 14(7): 726 - 738. [Abstract] [Full Text] [PDF]
|
|