Second malignancies in patients treated for Hodgkin's disease

Abstract

to analyse the incidence of second malignant neoplasms (SMN) in patients treated for Hodgkin s disease. Since 1(st) January 1967, 534 patients have received primary treatment for Hodgkin s disease and 470 cases have proved to be adequate for data analysis as regards to the development of SMN. SMN developed in 34 cases (7.2%), solid neoplasms were diagnosed in 26 cases (5.5%), lung neoplasms had the greatest incidence (11/26), hematologic malignancies were detected in 8 cases (1.7%), and non-Hodgkin s lymphoma was found in 5/8 cases. The mean age of patients with solid neoplasms was 38.1 years (18-59 years) at the diagnosis of Hodgkin s disease and the length of time until the diagnosis of SMN was 13.5 years (1-33 years). The mean age of patients with hematologic malignancies was 45 years (17-64 years), the latency period was 3.2 years (9 months-12 years). The therapies employed prior to the development of solid neoplasms involve: irradiation in 6 cases, chemotherapy in 8 and combined therapy in 12 cases. Out of the 20 cases of chemotherapy, CV/O/PP and its variants were used in 17 cases. Prior to the development of hematologic malignancies, 5 patients had received chemotherapy, 3 combined therapy and 7 patients CV/O/PP and its variants. The incidence of SMN, especially as regards to hematologic malignancies, was found lower in our patients as compared to literary data. This can be explained by the less intensive therapeutic techniques employed earlier as well as by shorter survival periods. As a result of better therapeutic management, the chances of long term survivals have increased and we should make every effort to avoid late complications such as SMN when planning therapeutic strategies.