Elevated Risk of Solid Tumor Persists Decades Later in Pediatric Hodgkin Lymphoma Survivors

A study published in Cancer found that survivors of childhood Hodgkin lymphoma (HL) remain at an increased risk of developing solid subsequent malignant neoplasms (SMNs), even four decades after childhood cancer. 

The large, ongoing, multinational Late Effects Study Group cohort was established in 1979 and follows children and adolescents (≤16 years) who were diagnosed with cancer between 1955 and 1979. In this cohort, there are 1,136 patients with HL. 

After a median follow-up of 26.5 years at publication, the cumulative incidence of any solid SMN was 26.4% 40 years after a diagnosis of HL. Specifically, in the HL cohort, 162 patients had a total of 196 solid SMNs, representing a 14-fold increased risk of developing a solid SMN compared with the general population (95% CI, 12.0-16.3). 

Patients who received radiotherapy had an associated risk of breast, lung, colon, and thyroid cancers. Of note, the patients in the study cohort were treated with larger doses of radiation than are used now. 

Specifically, risk factors for breast cancer among females were an HL diagnosis between 10 and 16 years of age and receipt of chest radiotherapy. Males treated with chest radiotherapy at <10 years were at the highest risk of developing lung cancer. Survivors of HL who were treated with abdominal/pelvic radiotherapy and high-dose alkylating agents were at the highest risk of developing colorectal cancer. Females exposed to neck radiotherapy at <10 years were at the highest risk of thyroid cancer.

By 50 years of age, the cumulative incidence of breast, lung, colorectal, and thyroid cancer was 45.3%, 4.2%, 9.5%, and 17.3%, respectively, among patients at highest risk. 

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Source: Cancer