Second lymphoid malignant neoplasms occurring in patients treated for Hodgkin's disease

Abstract

Patients who have been treated for Hodgkins disease are at increased risk for second malignant neoplasms, particularly acute nonlymphoblastic leukemia and non-Hodgkin''s lymphoid malignant neoplasms (NHLM). Five cases of NHLM were diagnosed in 242 patients initially treated for Hodgkin''s disease between 1973-1980, giving a minimum incidence for this occurrence of 2.1%. The initial therapy for Hodgkin''s disease, irradiation in 3 patients and chemotherapy in 2 patients, resulted in a complete remission in each case. The NHLM appeared 12, 13, 26, 30 and 54 mo. after the diagnosis of Hodgkin''s disease. The cell type of NHLM and immunologic phenotype were as follows: large cell, immunoblastic T cell; large cell, immunoblastic null cell; large cell, cleaved and noncleaved B cell; large cell, cleaved and noncleaved (not studied); lymphoblastic T cell. A review of 24 other cases of NHLM, occurring in patients treated for Hodgkin''s disease reported in the literature, confirm the morphologic and immunologic heterogeneity. The poor response to therapy in these patients and those previously described demonstrate the seriousness of this phenomenon.