ORLANDO—Treatments credited with improving 5-year survival rates for patients with childhood Hodgkin’s disease may lead to an increased risk of leukemia, breast cancer, and other neoplasms years later, according to a study by the Late Effects Study Group (LESG) presented at the American Society of Hematology annual meeting (abstract 3198).
Smita Bhatia, MD, MPH, director of Epidemiology and Outcomes Research, Pediatric Hematology and Oncology, City of Hope National Medical Center, Los Angeles, presented updated findings from a retrospective statistical analysis to determine the incidence of second cancers and the associated risk factors.
Prior studies had shown late effects of Hodgkin’s disease therapy, including second cancers, endocrine and pulmonary dysfunction, and cardiac compromise. "The most devastating of all is second cancers," Dr. Bhatia said. "There was a 7-fold to 10-fold increase, with females being at excess risk."
1,380 Hodgkin’s Disease Survivors
Dr. Bhatia’s team analyzed data from the clinical records of 1,380 Hodgkin’s disease survivors. Patients had been diagnosed in childhood, between 1955 and 1986. The median age at diagnosis was 11 years (range, 1 to 16). The LESG includes patients from 15 North American and European centers.
Median follow-up for this analysis was 15 years, with some patients followed for up to 45 years. Males comprised 65% of the group. Eight percent had received only chemotherapy, 23% had received only radiation therapy, and 69% both.
A total of 146 patients developed a second cancer, 112 solid tumors, 28 leukemias, and 6 non-Hodgkin’s lymphomas. A multivariate analysis showed that the relative risk of second cancers was greater for those diagnosed between ages 10 and 16, those who received both chemotherapy and radiation therapy, and those who had a recurrence.
