According to a study published in the Journal of the National Cancer Institute, the risk of developing acute myeloid leukemia (AML) after treatment for Hodgkin’s lymphoma has declined over time. This decline may be due to changes in the chemotherapy regimens used to treat Hodgkin’s lymphoma.
Hodgkin’s lymphoma is a cancer of the lymph system. It is diagnosed by the identification of a characteristic cell under the microscope (the Reed-Sternberg cell). Hodgkin’s lymphoma typically begins in the lymph nodes in one region of the body and then spreads through the lymph system in a predictable manner. It may spread outside the lymph system to other organs such as the lungs, liver, bone, and bone marrow.
Because Hodgkin’s lymphoma is a very curable cancer, research has focused on the quality of life for survivors of the disease, as well as potential medical complications they may face. Previous studies have indicated that survivors of Hodgkin’s lymphoma have a greatly increased risk of subsequently developing acute myeloid leukemia. Acute myeloid leukemia (AML) is a cancer of the bone marrow and blood, which is characterized by the rapid uncontrolled growth of immature white blood cells known as myelocytes.
In order to better understand the risk of AML in patients treated for Hodgkin’s lymphoma, researchers evaluated 35,511 patients who had been diagnosed with Hodgkin’s lymphoma between 1970 and 2001. The patients were identified from cancer registries in North American and Scandinavia. Researchers observed the following:
- 217 of the patients with Hodgkin’s lymphoma subsequently developed AML.
- The excess risk of AML (the difference in risk between patients with Hodgkin’s lymphoma and the general population) was greatest during the first 10 years after diagnosis of Hodgkin’s lymphoma.
- The excess risk of AML was greater for patients diagnosed with Hodgkin’s lymphoma at age 35 or older than for patients diagnosed at a younger age.
- The excess risk of AML was lower for patients diagnosed with Hodgkin’s lymphoma after 1984 than for patients diagnosed before 1984.
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The researchers conclude that although patients treated for Hodgkin’s lymphoma still have a greater risk of developing AML than the general population, the risk of developing AML after Hodgkin’s lymphoma has declined over time. This reduction in the risk of AML is most likely due to changes in the chemotherapy regimens used to treat Hodgkin’s lymphoma.
Reference: Schonfeld SJ, Gilbert ES, Dores GM et al. Acute Myeloid Leukemia Following Hodgkin Lymphoma: A Population-Based Study of 35,511 Patients. Journal of the National Cancer Institute. 2006;98:215-218.
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