Second malignant neoplasms in patients with non hodgkin's lymphoma

Abstract

A retrospective review of the records of 3886 patients with non-Hodgkin's lymphoma registered at the Princess Margaret Hospital between 1970 and 1985 was undertaken to determine the incidence of second malignant tumours. Three thousand and twenty-one patients with a minimum documented follow-up of 6 months from referral were identified for analysis. The overall observed/expected ratio for all cancers in patients with malignant lymphoma was 1, suggesting no increased risk of developing a second malignant neoplasm compared to the general population. When the data were analyzed independently for each tumour site, statistically significant increased risk of developing acute non lymphocytic leukemia (ANLL) (p less than 0.001) and carcinoma of the tongue (p less than 0.05) were found. An increased risk of lung cancer following lymphoma was detected but was not statistically significant. Survival following diagnosis of ANLL and lung cancer was similar and significantly shorter than that following the diagnosis of other second malignancies. The risk of developing a second primary cancer was significantly related to increasing patient age.

Risk of Second Malignancy After Non-Hodgkin's Lymphoma: A British Cohort Study

“…6,7,9,[11][12][13] The relative risk was even greater (200-fold) in children. 23 High relative risks have been linked to alkylating chemotherapy, including chlorambucil and cyclophosphamide specifically, 17 which were associated with raised risk in our data, and have been shown to be leukemogenic when used to treat Hodgkin's disease and other malignancies.…”

“…18,19 Raised risk of bladder cancer has been linked to cumulative doses of cyclophosphamide and, to a lesser extent, to radiotherapy. 20, 21 There have been sporadic reports of raised risk of several other solid cancers 5,6,8,9,13,20,21 and Hodgkin's disease, 9,22 but inconsistently and without an established relationship to treatment.…”

“…Several studies, [5][6][7][8][9] but not all, [10][11][12][13][14] have reported an elevated risk of second malignancy overall following NHL. Most studies have found increased risks of leukemia, especially acute nonlymphocytic leukemia (ANLL), 6,9,11,[14][15][16][17] associated with alkylating chemotherapy, alone or in combination with total nodal/body irradiation.…”

Is Systemic Immunosuppression a Risk Factor for Oral Cancer? A Systematic Review and Meta-Analysis

“…The risk of bias is summarized in Figure 2 and Figure 3 . The methodological quality of the included studies was high for 12 studies [ 19 , 22 , 24 , 25 , 28 , 31 , 32 , 33 , 36 , 51 , 53 , 58 ], moderate for 26 studies [ 20 , 21 , 23 , 25 , 26 , 29 , 30 , 32 , 34 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 54 , 55 , 56 , 57 , 60 , 61 , 62 ], and low for six studies [ 23 , 26 , 27 , 35 , 48 , 59 ].…”

“… Risk of bias summary [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. …”