Reactions 556 - 24 Jun 1995

Antineoplastics/radiotherapy

Carcinogenesis in patients with Hodgkin’s disease:incidence study

The results of a case cohort study of 10 472 patients fromthe USA and Canada showed an increased risk of leukaemiaand solid tumours in patients who received treatment withantineoplastics or radiotherapy for Hodgkin’s disease.

122 leukaemias and 438 solid tumours were observedamongst the group of patients. The median age at diagnosis ofHodgkin’s disease was 29 years and after excluding the firstyear after diagnosis, the average length of follow-up was 7.1years per patient.

Compared with controls, the overall relative risk ofleukaemia and solid tumours following antineoplastic therapywas found to be 14 and 1.4, respectively, and the relative riskof leukaemia and solid tumours following radiotherapy was1.2 and 0.9, respectively.

Exposure to chlorambucil, procarbazine, vinblastine and agroup of rarely used agents (including methotrexate, vindesineand etoposide) resulted in a statistically significant effect onleukaemia risk.

Therapy with the combined regimen of mechlorethamine,vincristine, procarbazine and prednisone (MOPP) wasassociated with a relative risk of leukaemia of 5.9.

For antineoplastic therapy the relative risk of cancers of thebones, joints, articular cartilage and soft tissues was 6 and therelative risk for cancers of the female genital system was 1.8.

For those patients who were treated with radiotherapy andfollowed for over 10 years it was found that the relative risk ofcancers of the respiratory system and intrathoracic organs was2.7 and the relative risk for cancers of female genital systemwas 2.4.

Author comment: ‘It is widely recognized that the benefitsof treatment of Hodgkin’s disease, in terms of survival,outweigh the risk of a subsequent malignancy. The assessmentof second cancer risk continues, however, to be essential indetermining the balance of the risks and benefits of treatment.’This study confirmed the well-known association betweenMOPP and leukaemia risk.Boivin J-F, et al. Incidence of second cancers in patients treated for Hodgkin’sdisease. Journal of the National Cancer Institute 87: 732-741, 17 May 1995 -USA 800365235

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Reactions 24 Jun 1995 No. 5560114-9954/10/0556-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved