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Second malignancies after treatment of classical Hodgkin lymphoma

Authors
Peter M Mauch, MD
Ann S LaCasce, MD
Section Editor
Arnold S Freedman, MD
Deputy Editor
Alan G Rosmarin, MD

INTRODUCTION

As the majority of patients with Hodgkin lymphoma (formerly called Hodgkin's disease, HL) are able to achieve long-term survival free of HL, late complications of treatment have emerged as a competing cause of death and morbidity. Long-term survivors are at risk for developing second malignancies, cardiovascular disease (eg, due to anthracycline toxicity or mediastinal radiation), pulmonary disease (eg, due to radiation and/or bleomycin), thyroid dysfunction, sterility, and other complications.

This topic review will discuss the second malignancies that are commonly seen in patients who have been treated for HL. Other complications are presented separately, as are recommendations for the long-term follow-up of patients with HL and the risk of second malignancy after hematopoietic cell transplantation. (See "Cardiotoxicity of anthracycline-like chemotherapy agents" and "Bleomycin-induced lung injury" and "Long-term follow-up of the patient with classical Hodgkin lymphoma", section on 'Follow-up for long-term complications' and "Malignancy after hematopoietic cell transplantation".)

GENERAL OBSERVATIONS

Patients treated with chemotherapy and/or radiotherapy for Hodgkin lymphoma (HL) have an increased risk of developing non-Hodgkin lymphoma (NHL) and solid tumors when compared with the general population [1-4]. These second cancers have a significant impact on survival from HL. The relative risk of developing a second malignancy has varied greatly among studies and is dependent upon a number of patient and treatment factors, including:

Radiation dose and fields

Chemotherapy agents and doses administered

                                  

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Literature review current through: Nov 2016. | This topic last updated: Wed Jan 27 00:00:00 GMT+00:00 2016.
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