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Assessing Frequency of Secondary Malignancies in Survivors of Hodgkin Lymphoma

A single institution study conducted at the Ospedale Oncologico di Riferimento Regionale (Italy) provided data on the cumulative incidence of secondary malignancies after treatment for Hodgkin lymphoma.

Results of the study were published at the European Hematology Association (EHA) Virtual Meeting (June 11-21, 2020).

Advancements in therapy options for patients with Hodgkin lymphoma have led to an increasing number of long-term survivors of the disease. However, survivors are at high risk of developing therapy-related complications that can impact long-term survival and quality of life.

Maria Pina Simula, MD, and colleagues followed 288 patients with previous Hodgkin lymphoma who were treated at Ospedale Oncologico di Riferimento Regionale from September 2014 to June 2019. Researchers collected data on secondary malignancies as well as the role of potential risk factors including number of therapy lines, type of therapy, previous radiotherapy, autologous hematopoietic stem cell transplantation (aHSCT), and splenectomy.

Researchers calculated the cumulative incidence of secondary malignancies using a Kaplan-Meier curve.

Results of the analysis showed that 22% (n = 63) of patients experienced a secondary cancer. Additionally, 10 patients experienced two secondary malignancies and one patient experienced three secondary malignancies. Researchers documented a total of 74 secondary tumors, 64% (n = 47) of which were non-cutaneous cancers and 36% (n = 27) of which were skin cancers. Three of the cutaneous neoplasms were melanomas, they noted.

The median time between end of Hodgkin lymphoma therapy and diagnosis of secondary malignancy was 21 years, they added. As for previous therapy, 86% (n = 247) of patients had received only one line of therapy. Fifty-eight percent (n = 166) of patients had been treated with ABVD as the only chemotherapy regimen, and 84% (n = 140) of these patients followed ABVD with radiotherapy. Eighty-two percent (n = 235) of the total patient population underwent previous radiotherapy, 8% (n = 22) underwent aHSCT, and 10% (n = 28) underwent splenectomy.

“These results outline the importance of continuous follow-up and risk adapted plans for early diagnosis of cancers in this setting of patients whose expectations and quality of life are clearly impaired,” authors of the study concluded, adding that surveillance should be the responsibility of both hematologists and general practitioners.—Zachary Bessette

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