FaCD Online Syndrome Fact Sheet
Last updated: 1 Jun 2003
Name: Non-Hodgkin Lymphoma, Multiple Primary Malignancies in Patients with
Tumor featuresHodgkin disease (Hodgkin's lymphoma) melanoma, cutaneous non-Hodgkin lymphoma urinary bladder cancer
Tumor features (possible)glioma of the brain lip, squamous cell cancer of the lung/bronchial cancer renal cell cancer soft tissue sarcoma thyroid cancer tongue cancer
Comment
A range of second primary cancers has been reported in patients with non-Hodgkin lymphoma (NHL). Brennan et al.[1] analyzed the occurrence of second primary neoplasms following NHL in 12,452 patients from the New South Wales Central Cancer Registry. They observed excesses of cutaneous melanoma (SIR = 2.38, 95% CI 1.92-2.91), lip cancer (2.74, 1.59-4.38), tongue cancer (2.53, 1.09-4.99), bladder cancer (1.64, 1.19-2.21), soft tissue sarcomas (3.61, 1.80-6.45) and thyroid cancer (3.42, 1.56-6.49).
Travis et al.[2] studied the risk of second cancer in 6171 NHL patients from 4 different international tumor registries. Approximately 1000 of these patients lived 15 or more years after diagnosis. Significant excess was seen for acute nonlymphocytic leukemia (AML) (Observed/Expected = 4.83), melanoma (2.38), Hodgkin's disease (12.0), and cancers of the lung (1.36), brain (2.33), kidney (2.07), and bladder (1.77). The authors concluded that NHL patients continue to be at significantly elevated risk of second primary cancer for up to two decades following diagnosis.
Levi et al.[3] observed an excess of NHL following squamous cell skin cancer (SIR 2.6, 95% CI 1.6-3.8) or basal cell skin cancer (1.9, 1.4-2.6) in approximately 15,000 Swiss non-melanoma skin cancer patients.
General aspects to consider with respect to multiple primary tumors:
- Shared genetic (immune response, metabolic/hormonal/DNA-repair pathways) or non-genetic (chemical carcinogens, radiation, viruses, life-style) risk factors
- Therapy (radiation, chemotherapy, hormonal) related effects
- Possible bias because of increased surveillance and autopsy findings.
References
[1] Brennan P, Coates M, Armstrong B, Colin D, Boffetta P. Second primary neoplasms following non-Hodgkin's lymphoma in New South Wales, Australia. Br J Cancer 2000; 82(7):1344-1347.
[2] Travis LB, Curtis RE, Glimelius B, Holowaty E, van Leeuwen FE, Lynch CF, Adami J, Gospodarowicz M, Wacholder S, Inskip P, . Second cancers among long-term survivors of non-Hodgkin's lymphoma. J Natl Cancer Inst 1993; 85(23):1932-1937.
[3] Levi F, Randimbison L, Te VC, La Vecchia C. Non-Hodgkin's lymphomas, chronic lymphocytic leukaemias and skin cancers. Br J Cancer 74[11], 1847-1850. 1996.
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