PB1999 SECOND MALIGNANCIES IN LYMPHOMA SURVIVORS: A SINGLE CENTER EXPERIENCE

Abstract

Background: Advances in the treatment of both Hodgkin's (HL) and non Hodgkin's Lymphomas (NHL) have resulted in an increasing number of long term survivors free of disease. However this patient's population is at high risk of developing late therapy related complications that can negatively affect long term survival and quality of life. Aims: Methods: In our institution the HL and aggressive NHL long term survivors are followed up in a dedicated clinic since September 2014. Here we report an update of data on second malignancies diagnosed after lymphoma resolution. We have collected retrospective data on second tumours in 587 consecutive lymphoma survivors. Results: We have analyzed data regarding 587 patients coming in our clinic from 15 September 2014 to 21 February 2019, 284 have been successfully treated for HL and 303 for NHL. Two hundred eighty six were females, 301 males; median of age at lymphoma diagnosis was 28 years for HL (range 7-84) and 46 years for NHL (range 14-83). Ninety six patients (16%) experienced a second cancer, 12 and 1 of them had respectively 2 and 3 neoplasms so we documented 110 second tumours. They were: 35 skin (32%) and 75 non cutaneous cancers (68%). Four of the cutaneous neoplasm were melanomas. The non skin neoplasm were: 21 breast, 12 gastroenteric, 10 thyroid, 8 prostatic, 2 lung, 9 bladder, 1 renal, 1 tongue, 1 testis, 2 ovarian,2 uterine, 1 laringeal, 1 meningioma, 1 myelodysplastic syndrome (MDS) with excess blasts, 1 melanoma urinary tract, 1 cutaneous marginal NHL and 1 cutaneous appendages malignant cancers. Fourteen of these tumours (3 colon, 6 breast, 2 thyroid,1 prostatic, 1 MDS and 1 ovarian) have been suspected during our annual visit or diagnosed with our program of early diagnosis of second cancers and thyroid dysfunctions. The median of time between the end of lymphoma therapy and diagnosis of second malignancy was 18 years (range 4-47), the median age of second cancer was 58 years (range 24-83). Regarding the previous therapies: 32 patients had received radiotherapies in the site of secondary tumours (33%) and 21 had more than 1 line of therapy (22%). Moreover we have documented relapse of their original lymphoma in 6 patients (1 HL and 5 NHL). Summary/Conclusion: In our Department we described a significant number of cases of second neoplasms in the lymphoma survivors population: some of these were detected by tests done for early diagnosis of late complications. These results outline the importance of continuous follow up and risk adapted plan for early diagnosis of cancers in this setting of patients that would be encouraged by both hematologist and general practitioners.