Incidence of Secondary Leukemias After Therapy of Childhood Hodgkin’s Disease Without Nitrogen-Mustard. Results of the German-Austrian Study Group

  • G. Schellong
  • M. Riepenhausen
  • U. Creutzig
  • J. Ritter
  • J. Harbott
  • G. Mann
  • H. Gadner
Conference paper
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 38)

Abstract

For more than 20 years now, secondary leukemias following treatment of Hodgkin’s disease (HD) have been reported in the literature [1–7]. Most of these reports refer to adults— corresponding to the higher incidence of HD in adults compared to children but cases following treatment in childhood have also been published. Usually these secondary leukemias present as acute myeloid leukemia (AML), with or without a myelodyplastic prephase, and have a very poor prognosis. As to causative factors, it became increasingly evident that specific elements of the chemotherapy are dicrectly responsible. Retrospective studies were able to identify alkylating cytotoxic agents as the main risk factor, especially nitrogen-mustard (synonymsimechlorethamine, mustargen) [8–12]. Today it is widely accepted that the mustine vincristine procarbazine and prednisone (MOPP) combination is associated with a considerably higher risk for secondary leukemias than ABVD which includes no alkylating drug [8, 12].

Keywords

Lymphoma Leukemia Oncol Cyclophosphamide Myeloma 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Canellos G.P., V.T. De Vita, J.C. Arseneau, et al. : Second malignancies complicating Hodgkin’s disease in remission. Lancet 1 (1975) 94–949Google Scholar
  2. 2.
    Cadman E.C., R.L. Capizzi, J.R. Bertino: Acute non-lymphocytic leukemia. A delayed complication of Hodgkin’s disease therapy: analysis of 109 cases. Cancer 40 (1977) 1280PubMedCrossRefGoogle Scholar
  3. 3.
    Coleman C.N., C.J. Williams, A. Flint, E.J. Glatstein, S.A. Rosenberg, H.S. Kaplan: Hematologic neoplasis in patients treated for Hodgkin’s disease. N.Engl. J.Med.29 (1977) 1249CrossRefGoogle Scholar
  4. 4.
    Valagussa P., A. Santro, R. Kenda, F. Fossati-Bellani, F. Franchi, A. Banfi, F. Rilke, G. Bonadonna: Second malignancies in Hodgkin’s disease: a complication of certain forms of treatment. Br.Med.J. 280 (1980) 216PubMedCrossRefGoogle Scholar
  5. 5.
    Pedersen-Bjergaard J., S.O. Larsen: Incidence of acute non-lymphocytic leukemia, preleukemia, and acute myeloproliferative syndrome up to 10 years after treatment of Hodgkin’s disease. N.Engl.Journ.Med. 16 (1982) 966–971Google Scholar
  6. 6.
    Sullivan M.P., I. Ramirez, H.L.Ried: Second malignancies following Hodgkin’s disease in children differ from those of adults: incidence occurring among 228 pediatric HD patients. Proc. Am. Assoc Cancer Res. 24 (1983) 160Google Scholar
  7. 7.
    Tester W.J., T.J. Kinsella, B. Waller, et al. : Second malignant neoplasms complicating Hodgkin’s disease: the National Cancer Institute experience. J. Clin. Oncol. (1984) 2: 762–769PubMedGoogle Scholar
  8. 8.
    Valagussa P., A. Santoro, F. Fpssato-Bellani, A. Banti, G. Bonadonna: Second acute leukemia and other malignancies following treatment for Hodgkin’s disease. J.Clin.Oncol. 4 (1986) 830–837PubMedGoogle Scholar
  9. 9.
    Tucker M.A., A.T. Meadows, J.D. Boice, M. Stovall, O. Oberlin, B.J. Stone, J. Birch, P.A. Voute, R.N. Hoover, J.F. Fraumeni for the Late Effects Study Group: Leukemia after therapy with alkylating agents for childhood cancer. J.Nat.Cancer Oncol. 4 (1987) 459–464Google Scholar
  10. 10.
    Pedersen-Bjergaard J., S.O. Larsen, J. Struck, H.H. Hansen, L. Specht, J. Ersboll, M.M. Hansen, N.I. Nissen: Risk of therapy-related leukemia and preleukemia after Hodgkin’s disease.Lancet 2 (1987)83–88PubMedCrossRefGoogle Scholar
  11. 11.
    Van der Velden J.W., W.L.J, van Putten, V.F. Guinee et al. : Subsequent development of acute nonlymphatic leukemia in patients treated for Hodgkin’s disease. Int. J. Cancer 42 (1988) 252–255PubMedCrossRefGoogle Scholar
  12. 12.
    Henry-Amar M., B. Pellae-Cosset, C. Bayle-Weisgerber, M.Hayat, J.M. Cosset, P. Carde, M. Tibina: Risk of secondary acute leukemia and preleukemia after Hodgkin’s disease: the institut Gustave Roussy experience. Rec. Results Cancer Res. 11 (1989) 270–283Google Scholar
  13. 13.
    Meadows A.T., A.C. Obringer, O. Marrero, O. Oberlin, L. Robinson, F. Fossati-Bellani, D. Green, P.A. Voute, P. Morris-Jones, M. Greenberg, E. Baum, F. Ruymann: Second malignant neoplasms following childhood Hodgkin’s disease: treatment and splenectomy as risk factors. Med. Ped. Oncology 17 (1989) 477–484CrossRefGoogle Scholar
  14. 14.
    Blayney D.W., D.L. Longo, R.C. Young, M.H. Greene, S.M. Hubbard, M.G. Postal, P.L. Duffey, V.T. Jr. DeVita: Decreasing risk of leukemia with prolonged follow-up after chemotherapy and radiotherapy for Hodgkin’s disease. N. Engl. J. Med. 316 (1987) 710–714PubMedCrossRefGoogle Scholar
  15. 15.
    Breu H., G. Schellong, I. Grosch-Wönner, A. Jobke, H. Riehm, J. Ritter, J. Treuner, E.-W. Schwarze, M. Wannenmacher: Chemotherapy of different intensity and reduced radiotherapy of Hodgkin’s disease in childhood—a report on 170 patients of the cooperative study HD-78. Klin.Padiat. 194 (1982) 233–241CrossRefGoogle Scholar
  16. 16.
    Schellong G., J. Brämswig, R. Ludwig, V. Gerein, A. Jobke, H. Jürgens, H. Kabisch, B. Stollmann, P. Weinel, H. Gadner, E.-W. Schwarze, M. Wannenmacher: Combined modality treatment in over 200 children with Hodgkin’s disease: risk -adapted chemotherapy, low dose involved field irradiation and selective splenectomy. A report of the cooperative therapy study DAL-HD-82. Klin.Pädiat. 198 (1986) 137–146CrossRefGoogle Scholar
  17. 17.
    Schellong G., I. Hörnig, J. Brämswig, J.P.M. Bökkering, A. Steinhoff, R. Ludwig, D. Niethammer, A. Reiter, H.J.v. Lengerke, H. Heinecke, E.-W. Schwarze, R. Pötter, R.P. Müller, M. Wannenmacher: The value of procarbazine in the chemotherapy of Hodgkin’s disease—a report of the cooperative therapy study DAL-HD-85.Klin.Pädiat.200 (1988) 205–213CrossRefGoogle Scholar
  18. 18.
    Schellong G., I. Hornig-Franz, B. Rath, J. Ritter, M. Riepenhausen, H. Kabisch, B. Goldschmitt-Wuttge, P. Schmidt, D. Niethamer, G. Gaedicke, E.-W. Schwarze, R. Potter, M. Wannenmacher: Reduction of radiation dosage to 20-30 Gy in the frame work of a combined chemo-/radiotherapy in childhood Hodgkin’s disease – a report of the cooperative therapy study DAL-HD-87. Klin. Padiat. 206 (1994) 253–262CrossRefGoogle Scholar
  19. 19.
    Schellong G., I. Hörnig-Franz, for the German Study Group for Hodgkin’s disease in children and adolescents: Salvage therapy in childhood Hodgkin’s disease. In: Zander A.R., B. Barlogie (Eds) Autologous bone marrow transplantation for Hodgkin’s disease, non-Hodgkin’s lymphoma and multiple myeloma. Springer Verlag Berlin Heidelberg 1993, 8–10Google Scholar
  20. 20.
    Kalpan E.L., P. Meier: Non-parametric estimation from incomplete observations. J.A. Stat. Assoc 53 (1968) 457–481Google Scholar
  21. 21.
    Kalbfleisch J.D., R.L. Prentice: The statistical analysis of failure time data. New York, John Wiley & Sons, 1980Google Scholar
  22. 22.
    Mantel N.: Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemoth. Rep.50 (1966) 163–170Google Scholar
  23. 23.
    van Leeuwen, F.E., R. Somers, A.A.M. Hart: Splenectomy in Hodgkin’s disease and second leukemias. Lancet 2 (1987) 210–211PubMedCrossRefGoogle Scholar
  24. 24.
    Nelson, D.F., S. Cooper, M.G. Weston, P. Rubin: Second malignant neoplasms in patients treated for Hodgkin’s disease with radiotherapy or radiotherapy and chemotherapy. Cancer 48 (1981) 2386–2393PubMedCrossRefGoogle Scholar
  25. 25.
    Henry-Amar, M.: Second cancer after treatment for Hodgkin’s disease: a report from the International Database on Hodgkin’s Disease. Ann. Oncol. 3, Suppl. 4 (1992)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • G. Schellong
    • 1
  • M. Riepenhausen
    • 1
  • U. Creutzig
    • 1
  • J. Ritter
    • 1
  • J. Harbott
    • 2
  • G. Mann
    • 3
  • H. Gadner
    • 3
  1. 1.University Children’s HospitalMünsterGermany
  2. 2.University Children’s HospitalGießenGermany
  3. 3.St. Anna Children’s HospitalWienAustria

Personalised recommendations