Second cancers in Hodgkin's lymphoma long-term survivals: A 60-year single institutional experience with real-life cohort of 871 patients

Vyskocil, J; Grell, Peter; Májek, Ondřej; Soumarová, Renata; Novák, J; Burkoň, Petr; Král, Zdeněk; Kazda, Tomáš; Vyzula, Rostislav

doi:10.1111/ijcp.13235

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…In 771 FL patients from the pre-rituximab era, the risk ratio (RR) for leukaemia was 10Á4 (95% Cl: 4Á5-20Á5) (Mudie et al, 2006). In 871 Hodgkin lymphoma (HL) patients with a median follow-up of 12 years, the SIR was 5Á8 (95% Cl: 2Á3-12Á0) for secondary leukaemia (Petrakova et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era

Prusila

Sorigué²,

Jauhiainen

et al. 2019

Br J Haematol

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Summary Follicular lymphoma (FL) is the most common indolent lymphoma. Currently there are many comparable treatment options available for FL. When selecting the most optimal therapy it is important to consider possible late effects of the treatment as well as survival. Secondary haematological malignancy (SHM) is a severe late effect of treatments, but the incidence of SHMs is still largely unknown. The goal of the present study was to determine the incidence of SHMs and how therapeutic decisions interfere with this risk. The study included 1028 FL patients with a median follow‐up time of 5·6 years. The 5‐year risk of SHM was 1·1% and the risk was associated with multiple lines of treatment (P = 0·016). The 5‐year risk of SHM was 0·5% after the first‐line treatment and 1·6% after the second‐line. The standardized incidence ratio (SIR) was 6·2 (95% confidence interval 3·4–10·5) for SHM overall. This retrospective study found that the risk of SHM was low after first‐line treatment in FL patients from the rituximab era. However, the risk of SHM increases with multiple lines of treatment. Therapeutic approaches should aim to achieve as long a remission as possible with first‐line treatment, thereby postponing the added risk of SHM.

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Section: Discussionmentioning

confidence: 99%

Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era

Prusila

Sorigué²,

Jauhiainen

et al. 2019

Br J Haematol

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“…In a study of the follow-up of patients after treatment for Hodgkin's lymphoma 8 , in a single center, the risk of developing the second cancer was 80.8%. Breast cancer was the second most frequent, second only to lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer after chest irradiation for lymphoma: case report

Fontinele

Vieira

2020

Mastology

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Breast cancer is one of the most common diseases among women worldwide. One of the risk factors for the development of this neoplasia is previous radiotherapy on the chest wall. Breast cancer, in turn, is the main long-term concern among women treated for lymphoma with radiation on the chest wall. Thus, we present a case of breast cancer that appeared 18 years after chest radiation for the treatment of lymphoma.

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“…Intensity modulated proton therapy (IMPT) in DIBH may have an additional benefit [30]. A recent and large analysis of the rate of second cancers in Hodgkin survivors treated at a median age of 34 years revealed that the most common second cancer is lung cancer in 17.5% of all patients with a general standardized incidence ratio of 2.9 [31]. In order to mitigate the risk for secondary malignancy in the lungs the dose distribution for our patients was anterior-posterior weighted and the reduced lung dose by DIBH may also contribute to lower this risk.…”

Section: Discussionmentioning

confidence: 99%

DIBH-VMAT for Consolidation RT in Mediastinal B-NHL can Significantly Reduce Doses to OAR Report of Two Cases

Fahrig¹,

Koch²,

Heine³

et al. 2019

Int J Radiol Imaging Technol

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has shown to improve significantly both overall survival (OS) and progression-free survival (PFS) even in the rituximab era significantly and also in patients with nonbulky-disease [1-3]. The advances with chemotherapy and radiotherapy have considerably increased the survival rates. Most of the patients are in a middle age of 50 to 60 years and the treatment is in principle curative with a five year PFS of 75-90%. Therefore on the one hand, DLBCL has to be adequately treated to reach a curative outcome, on the other hand RT-delivery should avoid critical dose burden to organs at risk, i.e. especially the heart and the lungs, in order to reduce late cardiac morbidity and the risk for secondary lung cancer. In Hodgkin´s disease, the relative risk (RR) of secondary lung cancer increases considerably in relation to the dose of ionizing radiation, with a RR of 9.6 when more than 9 Gy are administered [4]. Less is known about the correlation between NHL and second lung cancer. Although, the RR is higher in long-term NHL survivors than in healthy individuals. The risk for cardiac mortality and secondary cancers can be estimated using calculation models. Toltz, et al. used the relative seriality model to predict excess risk of cardiac mortality and a modified linear quadratic model to predict the Excess Absolute Risk (EAR) for induction of lung cancer and breast cancer in patients with Hodgkin´s Lymphoma, NHL or breast cancer [5]. They compared the results of 3D conformal photon radiotherapy (3D-CRT) and intensity modulated proton therapy (IMPT). The excess risk of cardiac mor-Abstract Background: Consolidative radiotherapy after immunochemotherapy in localized bulky diffuse large B-cell lymphoma (DLBCL) patients significantly improves both, overall and progression-free survival and treatment is in principle curative. Therefore protection of organs at risk is highly relevant. Case, planning and results: Two 53-years and 18-years old patients with bulky mediastinal DLBCL were planned with and without deep inspiration breath-hold (DIBH) and volumetric modulated arc therapy (VMAT). DIBH reduced the doses to the heart and the lungs while homogeneity and conformity were not compromised. The number of Monitor Units (MU) needed was significantly reduced by DIBH-VMAT. Both patients were treated in DIBH-VMAT. Conclusion: Planning with DIBH in bulky mediastinal DLBCL is feasible and should be taken into account due to the high relevance with regard to acute and late toxicity.

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Second cancers in Hodgkin's lymphoma long-term survivals: A 60-year single institutional experience with real-life cohort of 871 patients

Cited by 8 publications

References 27 publications

Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era

Risk of secondary haematological malignancies in patients with follicular lymphoma: an analysis of 1028 patients treated in the rituximab era

Breast cancer after chest irradiation for lymphoma: case report

DIBH-VMAT for Consolidation RT in Mediastinal B-NHL can Significantly Reduce Doses to OAR Report of Two Cases

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