Age over Fifty-Five Years at Diagnosis Increases Risk of Second Malignancies after Autologous Transplantation for Patients with Hodgkin Lymphoma

Pingali, Sai Ravi; Saliba, Rima M.; Anderlini, Paolo; Hosing, Chitra; Khouri, Issa F.; Alousi, Amin M.; Nieto, Yago; Qazilbash, Muzaffar H.; Champlin, Richard E.; Popat, Uday

doi:10.1016/j.bbmt.2017.03.030

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…In their analysis of 154 patients who received ASCT, Minn et al [34] found a 15-year cumulative incidence of SM of 12%, but the RR of SM was similar to cHL patients who did not receive ASCT. Age >55 years at diagnosis of cHL was identified by Pingali et al [32] as a risk factor for SM.…”

Section: Discussionmentioning

confidence: 97%

“…Pingali et al [32] reported the results of a retrospective study involving 310 patients with relapsed or refractory cHL who received ASCT with BEAM conditioning and an ifosfamide-etoposide based mobilization. After a median follow-up of 80 months (range 1-180 months), the cumulative incidence of SM was 11% in the cohort, with 13 sMDS/sAML, three basal cell carcinomas, two squamous cell cancers, one prostate cancer, one myeloproliferative neoplasm, and one sarcoma.…”

Section: Different Therapies Including Ct and Rtmentioning

confidence: 99%

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Second Cancers in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma: A Systematic Review by the Fondazione Italiana Linfomi

Nassi

Sanctis²,

Loseto

et al. 2022

Cancers

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Background: The increase of lymphoma patient survival led to a modification of the incidence of long-term sequelae, including second malignancies (SM). Several groups have dealt with the incidence of SM, according to the primary treatment; however, a standardized approach for the early detection and screening of SM in the population of lymphoma survivors should be implemented. Methods: A systematic review was conducted by Fondazione Italiana Linfomi (FIL), in order to define the incidence of SM, the impact of modern radiotherapy on SM risk, and the usefulness of tailored follow-up and screening strategies for early diagnosis of SM. Classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) survivors were investigated. The MEDLINE, Embase, and Cochrane Library databases were checked for relevant reports published up to January 2020. The selection process was reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Results: A total of 27 full-text manuscripts resulted as eligible for the analysis. The incidence of SM in cHL patients treated with ABVD was higher compared to the general population and was even higher in patients treated with intensified regimens. The risk increased over time, as well as after 10–15 years from therapy, and was augmented by radiotherapy exposure. In DLBCL, more intensive regimens (i.e., R-CHOEP or R-MegaCHOEP) vs. R-CHOP were associated with a higher SM incidence. Salvage chemotherapy and autologous stem cell transplants increased the risk of SM in both cHL and DLBCL cohorts. A lower incidence of SM, particularly of breast cancer (BC), was shown in cohorts of cHL survivors treated with reduced radiation volumes and doses (involved fields vs. extended fields), but robust trials are still lacking. Considering the advantage of a structured screening for early detection of SM, all the included studies regarded cHL survivors and screening strategy for early BC detection. Moreover, the authors discuss additional papers, to guide the early diagnosis of lung, colorectal, skin, and thyroid cancer in patients at risk due to family history, drug or RT exposure, or unhealthy lifestyles. These screening strategies all passed through patient awareness. Conclusion: A modern approach to chemotherapy and radiotherapy led to a lower risk of SM, which should be confirmed over time. Early detection of secondary cancers could be achieved through a tailored screening program, according to the individual risk profile.

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Section: Discussionmentioning

confidence: 97%

Section: Different Therapies Including Ct and Rtmentioning

confidence: 99%

Second Cancers in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma: A Systematic Review by the Fondazione Italiana Linfomi

Nassi

Sanctis²,

Loseto

et al. 2022

Cancers

View full text Add to dashboard Cite

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Current Treatment Options for Older Patients with Hodgkin Lymphoma

Carter

David

Kritharis

et al. 2020

Curr. Treat. Options in Oncol.

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Older patients with Hodgkin Lymphoma: Walking the tightrope of efficacy and toxicity

Barrett

Collins

2023

Front. Oncol.

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Since its initial description, classical Hodgkin lymphoma (cHL) portends a greatly improved prognosis and the goal of treatment in most patients is cure with minimisation of toxicity from treatment. Outcomes in older patients (>60 years old) lag behind those of their younger counterparts however, and cure remains achievable mostly for those who can tolerate full doses of conventional chemotherapy. This review addresses the difference in biology between younger and older patients with cHL and examines the impact of frailty and comorbidities on outcomes. The toxicities of conventional chemotherapy in anthracycline-fit and -unfit patients are examined, with a particular focus on pulmonary toxicity associated with bleomycin in older patients. New advances are discussed, including the possibility of using more targeted therapies such as the anti-CD30 antibody brentuximab vedotin (BV) and checkpoint inhibitors as a method of reducing dependency on conventional chemotherapy for those less well able to tolerate it. Treatment of older patients with cHL remains an area of unmet need in hematological research, and efforts to rectify this knowledge gap should continue.

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Age over Fifty-Five Years at Diagnosis Increases Risk of Second Malignancies after Autologous Transplantation for Patients with Hodgkin Lymphoma

Cited by 3 publications

References 39 publications

Second Cancers in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma: A Systematic Review by the Fondazione Italiana Linfomi

Second Cancers in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma: A Systematic Review by the Fondazione Italiana Linfomi

Current Treatment Options for Older Patients with Hodgkin Lymphoma

Older patients with Hodgkin Lymphoma: Walking the tightrope of efficacy and toxicity

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