Advanced Stage of Diagnosis of NHL Significant for Secondary Malignancies

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British Journal of Cancer (2005) 93, 418-424.

doi:10.1038/sj.bjc.6602731

Second primary malignancies after treatment for malignant lymphoma

A Okines1, C S Thomson2, C R Radstone1, J M Horsman1 and B W Hancock1

1YCR Academic Unit of Clinical Oncology, Weston Park Hospital,

Whitham Road, Sheffield S10 2SJ, UK

2Trent Cancer Registry, 5 Old Fulwood Road, Sheffield S10 3TG, UK

Correspondence to: Professor BW Hancock, E-mail:

b.w.hancock@...

Received 17 January 2005; revised 6 July 2005; accepted 6 July 2005

To determine the incidence and possible causes of second primary

malignancies after treatment for Hodgkin's and Non-Hodgkin's lymphoma

(HL and NHL).

A cohort of 3764 consecutive patients diagnosed with HL or NHL

between January 1970 and July 2001 was identified using the Sheffield

Lymphoma Group database.

A search was undertaken for all patients diagnosed with a subsequent

primary malignancy. Two matched controls were identified for each

case. Odds ratios were calculated to detect and quantify any risk

factors in the cases compared to their matched controls. Mean follow-

up for the cohort was 5.2 years.

A total of 68 patients who developed second cancers at least 6 months

after their primary diagnosis were identified, giving a crude

incidence of 1.89% overall: 3.21% among the patients treated for HL,

1.32% in those treated for NHL.

Most common were bronchial, breast, colorectal and haematological

malignancies.

High stage at diagnosis almost reached statistical significance in

the analysis of just the NHL patients (odds ratio=3.48; P=0.068)

after adjustment for other factors. Treatment modality was not

statistically significant in any analysis.

High stage at diagnosis of NHL may be a risk factor for developing a

second primary cancer.