Excess AML Risk Greatest 10 Years After Hodgkin Diagnosis
Hodgkin's lymphoma survivors face a more than six-fold excess absolute risk of acute myeloid leukemia (AML), which is highest in the 10 years after Hodgkin's diagnosis, a large new population-based study shows.
The study also found that this excess risk has decreased significantly since 1984, probably due in changes in treatment, but it has not been eliminated.
The relative risk of AML is known to be substantial among Hodgkin's disease survivors, Dr. Sara J. Schonfeld of the National Cancer Institute and colleagues note, but no large study has looked specifically at excess absolute risk of AML in these patients while addressing factors such as age and year of diagnosis.
Dr. Schonfeld and her team looked at 35,511 one-year survivors of the disease included in 14 European and North American cancer registries who had been diagnosed with Hodgkin's lymphoma between 1970 and 2001.
Two hundred seventeen patients developed AML, while 10.8 cases would have been expected, for an unadjusted excess absolute risk of 6.2. Excess absolute risk was 7.9 in the first 10 years of Hodgkin's diagnosis, 4.6 from 10 to 14 years, and 1.3 by 15 years after diagnosis.
The researchers also found that excess absolute risk of AML was higher among patients who were 35 or older when they were diagnosed with Hodgkin's lymphoma compared to those who were younger. Patients diagnosed between 1970 and 1984 also had a greater excess absolute risk of AML than patients diagnosed between 1985 and 2001.
This difference was particularly pronounced for patients who had been treated with chemotherapy initially; these patients overall also showed a greater excess absolute risk of AML.
The chronological decrease in AML risk observed is likely due to changes in chemotherapy, Dr. Schonfeld and her colleagues write. "Analytic studies with detailed treatment data are required to correlate these decreases with changes in therapy and to better understand the long-term risk of AML after Hodgkin's lymphoma," they conclude.
The study also found that this excess risk has decreased significantly since 1984, probably due in changes in treatment, but it has not been eliminated.
The relative risk of AML is known to be substantial among Hodgkin's disease survivors, Dr. Sara J. Schonfeld of the National Cancer Institute and colleagues note, but no large study has looked specifically at excess absolute risk of AML in these patients while addressing factors such as age and year of diagnosis.
Dr. Schonfeld and her team looked at 35,511 one-year survivors of the disease included in 14 European and North American cancer registries who had been diagnosed with Hodgkin's lymphoma between 1970 and 2001.
Two hundred seventeen patients developed AML, while 10.8 cases would have been expected, for an unadjusted excess absolute risk of 6.2. Excess absolute risk was 7.9 in the first 10 years of Hodgkin's diagnosis, 4.6 from 10 to 14 years, and 1.3 by 15 years after diagnosis.
The researchers also found that excess absolute risk of AML was higher among patients who were 35 or older when they were diagnosed with Hodgkin's lymphoma compared to those who were younger. Patients diagnosed between 1970 and 1984 also had a greater excess absolute risk of AML than patients diagnosed between 1985 and 2001.
This difference was particularly pronounced for patients who had been treated with chemotherapy initially; these patients overall also showed a greater excess absolute risk of AML.
The chronological decrease in AML risk observed is likely due to changes in chemotherapy, Dr. Schonfeld and her colleagues write. "Analytic studies with detailed treatment data are required to correlate these decreases with changes in therapy and to better understand the long-term risk of AML after Hodgkin's lymphoma," they conclude.
posted by TM at 8:31 AM
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