Second neoplasms in patients with Hodgkin's disease following combined modality therapy--the Yale experience

Journal Article · Sat Mar 01 00:00:00 EST 1986 · J. Clin. Oncol.; (United States)

OSTI ID:5528637

Koletsky, A J; Bertino, J R; Farber, L R; Prosnitz, L R; Kapp, D S; Fischer, D; Portlock, C S

From 1969 to 1982, 183 patients with previously untreated stages IIIB and IV Hodgkin's disease and relapsing Hodgkin's disease after radiation therapy were treated with combination chemotherapy plus low-dose irradiation (CRT). One hundred fifty patients who achieved a complete response (CR) were analyzed for risk of developing a second neoplasm. Median follow-up has been 8.3 years. Actuarial survival of all patients is 74% at 10 years with a relapse-free survival of 68%. An additional 24 patients with stage IIIA disease were also treated with CRT. There were 22 CRs at risk who were analyzed. Median follow-up has been 3+ years with an actuarial survival of 90% at five years and a relapse-free survival of 83%. Second neoplasms have developed in 14 of 172 patients at risk: acute nonlymphocytic leukemia (ANLL; five patients); aggressive histology non-Hodgkin's lymphoma (NHL; three patients); and a variety of solid neoplasms (six patients). Time to second neoplasm diagnosis after initial treatment ranged from 12 to 141 months. Five patients were older than 40 years. At the time of diagnosis of the second malignancy, 11 patients were free of Hodgkin's disease (for 36 to 141 months) and three were receiving therapy for recurrent Hodgkin's disease. The 10-year actuarial risk (%) of developing ANLL was 5.9 +/- 2.8; for NHL, the risk was 3.5 +/- 2.4, and for solid neoplasms, 5.8 +/- 3.0. Our results suggest that combination chemotherapy plus low-dose irradiation does not appear to significantly increase the risk of developing second neoplasms above that already reported for combination chemotherapy when administered as either initial or salvage treatment of Hodgkin's disease.

• Research Organization: Yale Univ. School of Medicine, New Haven, CT
• OSTI ID: 5528637
• Journal Information: J. Clin. Oncol.; (United States), Vol. 3
• Country of Publication: United States
• Language: English

Related Subjects

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
62 RADIOLOGY AND NUCLEAR MEDICINE
HODGKINS DISEASE
RADIOTHERAPY
SIDE EFFECTS
CHEMOTHERAPY
LEUKEMIA
LOW DOSE IRRADIATION
NEOPLASMS
PATIENTS
SURVIVAL TIME
DISEASES
HEMIC DISEASES
IRRADIATION
LYMPHOMAS
MEDICINE
NUCLEAR MEDICINE
RADIOLOGY
THERAPY
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