Incidence and epidemiology of non‐Hodgkin lymphoma and risk of second malignancy among 22 466 survivors in Israel with 30 years of follow‐up

Abstract

Previous studies have shown an increase risk of second malignancies after non-Hodgkin's lymphoma (NHL), which is probably related to a combination of factors including genetic predisposition, molecular background, host immunological status and therapy administered. Here, we determined the incidence of NHL and risk of second solid tumours and haematological malignancies among survivors of NHL diagnosed in Israel during 1980-2011. Data were collected from the records of the Israeli National Cancer Registry. The total cohort of 24 666 NHL-patients included 22 601 Jews and 2065 Arabs. Median age of diagnosis for Jews was 61.3 years and 48.2 for Arab patients. Of the Jews with NHL, 11 265 (50%) were of European-American origin, 5005 (22%) Asian or African and 6114 (27%) were born in Israel. Second cancers were recorded in 2010 NHL survivors, 1918 Jews and 92 Arabs, representing a rate of 8.5%, and 4.5% o, respectively. Second malignancies in all recorded sites were more frequent than in the general population, with a standardized incidence ratio (SIR) of 1.28 for Jewish men, 1.25 for Jewish women, 1.73 for Arab men and 1.98 for Arab women. This higher risk was even more pronounced for the 309 cases with secondary haematological malignancies (secondary haematological malignancies of 1.97, 1.81, 4.48 and 4.15, respectively). Our findings show that there is an increased risk of second malignancies occurring after diagnosis of NHL in Israel, particularly for haematological malignancies such as leukaemia and NHL. The differences we report in the incidence of NHL and the types of second malignancies occurring among Jews and Arabs suggest that ethnicity and genetic susceptibility may be important relevant risk factors. Copyright © 2016 John Wiley & Sons, Ltd.

Incidence and time trends of second primary malignancies after non-Hodgkin lymphoma: a Swedish population-based study

“…The excess risk of SPM in NHL demonstrated in our study is in line with previous literature, although prior studies vary in terms of design and sources of the study populations and most often lack data regarding subtypes [4][5][6][7][8][9][10][11][12][13][14] . In a 2011 meta-analysis Pirani et al found pooled relative risks of 1.88 for any secondary cancer, and relative risk of 1.32 for solid tumors among patients with NHL 11 .…”

“…Previous studies have consistently shown increased risks of SPM in general, and of myeloid malignancies in particular [4][5][6][7][8][9][10][11][12][13][14] . However, many of these studies have not investigated the most recent time periods with modern treatments, and have included small, sometimes selected, patient groups.…”

Second primary malignancies among cancer patients

“…When we chose SPM, we did not include some important parts, including the head and neck. And these are considered to be the location of SPM, and some are often fatal (27)(28)(29).…”

Classic Hodgkin Lymphoproliferative Diseases Clonally Unrelated to B-Chronic Lymphocytic Leukemia Successfully Treated with Bendamustine Plus Rituximab

“…Patients with hematologic malignancies treated with chemotherapy have increased risk of developing LPDs [6,7], being CLL/SLL the most frequently observed entity in these patients. Notably, patients treated with fludarabine appear to have a high predisposition for developing CR-LPDs with DLBCL accounting for the most common type of CR-LPDs arising in these cases, followed by polymorphic LPDs, and CHL [8].…”