Leukemia Risk after Hodgkin's Lymphoma Reduced in Recent Decades

The risk of developing acute myeloid leukemia (AML) after treatment for Hodgkin's lymphoma (HL) has decreased over the last three decades. In the early 1980s, the chemotherapy regimen changed in a way that may have influenced the development of secondary AML in HL survivors, a new study reports.

To determine whether patients treated after 1984 have decreased risks for AML, the researchers analyzed data on more than 35,000 1-year Hodgkin's lymphoma survivors who were reported to population-based cancer registries in North America and in Nordic countries between 1970 and 2001.

Of the survivors, 217 developed AML. The risks were higher for patients over age 35 at the time of their HL treatment, and if that treatment occurred between 1970 and 1984 (versus 1985-2001). The decline over time in the risk of secondary AML was particularly apparent among HL survivors who initially received any chemotherapy, the researchers report in the February 1 Journal of the National Cancer Institute (JNCI).

The analysis showed that excess absolute risk for secondary AML was highest during the first 10 years after HL diagnosis but remained elevated thereafter. Excess absolute risk is the risk that occurs in addition to the "background" risk for a disease that exists in the general population.

In the analysis, Dr. Lois B. Travis of NCI and colleagues simultaneously evaluated the effects of age, calendar year of and time since HL diagnosis, and initial course of treatment. More research is needed to correlate decreases in risk of secondary AML with changes in HL therapy because population-based cancer registries do not contain detailed data on treatment regimens or information on subsequent therapy.

The findings "demonstrate an overall reduction, although not elimination, in the burden of AML over calendar year time," the researchers write. "This likely reflects in part the changes in chemotherapy (given initially or at relapse) that were implemented over the last few decades." (NCI)

Mike's note: Most likely the use of ABVD Chemotherapy over MOPP (maybe even the ABV(D)/MOPP hybrid chemos) helped reduce the leukemia risk.

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