Risk of subsequent primary lymphoma in a cohort of 69,460 five-year survivors of childhood and adolescent cancer in Europe: The PanCareSurFup study.
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Dudley Isabelle M, Sunguc Ceren, Heymer Emma J, Winter David L, Teepen Jop C, Belle Fabiën N, Bárdi Edit, Bagnasco Francesca, Gudmundsdottir Thorgerdur, Skinner Roderick, Michel Gisela, Byrne Julianne, Øfstaas Hilde, Jankovic Momcilo, Mazić Maja Česen, Mader Luzius, Loonen Jaqueline, Garwicz Stanislaw, Wiebe Thomas, Alessi Daniela, Allodji Rodrigue S, Haddy Nadia, Grabow Desiree, Kaatsch Peter, Kaiser Melanie, Maule Milena M, Jakab Zsuzsanna, Gunnes Maria Winther, Terenziani Monica, Zaletel Lorna Zadravec, Kuehni Claudia E, Haupt Riccardo, de Vathaire Florent, Kremer Leontien C, Lähteenmäki Päivi M, Winther Jeanette F, Hjorth Lars, Hawkins Michael M, Reulen Raoul C
Аннотация
METHODS: The Pan-European Network for Care of Survivors After Childhood and Adolescent Cancer (PanCare) Survivor Care and Follow-Up Studies (PanCareSurFup) cohort includes 69,460 five-year survivors of childhood cancer, diagnosed during 1940 through 2008, from 12 European countries. Risks of SPLs were quantified by standardized incidence ratios (SIRs) and relative risks (RRs) using multivariable Poisson regression.
RESULTS: Overall, 140 SPLs, including 104 NHLs and 36 HLs, were identified. Survivors were at 60% increased risk of an SPL compared with the general population (SIR, 1.6; 95% confidence interval [CI], 1.4-1.9). Survivors were twice as likely to develop NHL (SIR, 2.3; 95% CI, 1.9-2.8), with the greatest risks among survivors of HL (SIR, 7.1; 95% CI, 5.1-10.0), Wilms tumor (SIR, 3.1; 95% CI, 1.7-5.7), leukemia (SIR, 2.8; 95% CI, 1.8-4.4), and bone sarcoma (SIR, 2.7; 95% CI, 1.4-5.4). Treatment with chemotherapy for any cancer doubled the RR of NHL (RR, 2.1; 95% CI, 1.2-3.9), but treatment with radiotherapy did not (RR, 1.2; 95% CI, 0.7-2.0). Survivors were at similar risk of developing a subsequent HL as the general population (SIR, 1.1; 95% CI, 0.8-1.5).
CONCLUSIONS: In addition to HL, the authors show here for the first time that survivors of Wilms tumor, leukemia, and bone sarcoma are at risk of NHL. Survivors and health care professionals should be aware of the risk of NHL in these survivors and in any survivors treated with chemotherapy.