Tweede tumoren na behandeling van de ziekte van Hodgkin

– The incidence of secondary tumours and the risk factors that contribute to their occurrence were studied in 744 patients who had been treated for Hodgkin's disease in the Netherlands Cancer Institute between 1966 and 1983. In this group, 16 patients developed leukaemia, 6, myelodysplasia, 9, non-Hodgkin lymphoma and 33, solid tumours of which 14 were lung carcinomas. Of all these secondary tumours, the observed number was statistically significantly larger than the expected number. The risk of secondary leukaemia was 46 times as high, that of non-Hodgkin lymphoma, 31 times and that of lung carcinoma, 5 times. The peak risk of leukaemia occurred 5-10 years after the diagnosis of Hodgkin's disease.

Risk factors for the occurrence of secondary leukaemia were intensity of the chemotherapy, age and also, splenectomy. The risk of a secondary non-Hodgkin lymphoma was influenced by the combination of radiotherapy and chemotherapy, while for lung carcinoma, radiotherapy was the major factor involved.