Risk of subsequent primary lymphoma in a cohort of 69,460 five‐year survivors of childhood and adolescent cancer in Europe: The PanCareSurFup study
Background Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SP...
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| Published in | Cancer Vol. 129; no. 3; pp. 426 - 440 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Wiley Subscription Services, Inc
01.02.2023
Wiley John Wiley and Sons Inc |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer survivors worldwide.
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.
Using data from 69,460 five‐year survivors of childhood cancer across Europe, the authors investigated the risks of subsequent primary lymphoma within the largest cohort reported to date. Novel findings include the identification of an increased risk of non‐Hodgkin lymphoma among survivors of Wilms tumor, leukemia, and bone sarcoma and in any survivors treated with chemotherapy. |
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| AbstractList | Background: Survivors of Hodgkin lymphoma (HL) are at risk of developing non-Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer survivors worldwide. 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. Using data from 69,460 five‐year survivors of childhood cancer across Europe, the authors investigated the risks of subsequent primary lymphoma within the largest cohort reported to date. Novel findings include the identification of an increased risk of non‐Hodgkin lymphoma among survivors of Wilms tumor, leukemia, and bone sarcoma and in any survivors treated with chemotherapy. BackgroundSurvivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer survivors worldwide.MethodsThe 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.ResultsOverall, 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).ConclusionsIn 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. Background Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer survivors worldwide. 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. Using data from 69,460 five‐year survivors of childhood cancer across Europe, the authors investigated the risks of subsequent primary lymphoma within the largest cohort reported to date. Novel findings include the identification of an increased risk of non‐Hodgkin lymphoma among survivors of Wilms tumor, leukemia, and bone sarcoma and in any survivors treated with chemotherapy. Survivors of Hodgkin lymphoma (HL) are at risk of developing non-Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer survivors worldwide. 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. 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). 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. Abstract Background Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary lymphomas (SPLs), including HL and NHL, after different types of childhood cancer are unknown. The authors quantified the risk of SPLs using the largest cohort of childhood cancer survivors worldwide. 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. Using data from 69,460 five‐year survivors of childhood cancer across Europe, the authors investigated the risks of subsequent primary lymphoma within the largest cohort reported to date. Novel findings include the identification of an increased risk of non‐Hodgkin lymphoma among survivors of Wilms tumor, leukemia, and bone sarcoma and in any survivors treated with chemotherapy. |
| Author | Michel, Gisela Garwicz, Stanislaw Hjorth, Lars Terenziani, Monica Kaatsch, Peter Haddy, Nadia Heymer, Emma J. Bárdi, Edit Mazić, Maja Česen Gudmundsdottir, Thorgerdur Mader, Luzius Belle, Fabiën N. Skinner, Roderick Maule, Milena M. Gunnes, Maria Winther Kremer, Leontien C. Winther, Jeanette F. Sunguc, Ceren Vathaire, Florent Byrne, Julianne Bagnasco, Francesca Haupt, Riccardo Zaletel, Lorna Zadravec Reulen, Raoul C. Allodji, Rodrigue S. Alessi, Daniela Jakab, Zsuzsanna Jankovic, Momcilo Grabow, Desiree Kaiser, Melanie Winter, David L. Lähteenmäki, Päivi M. Wiebe, Thomas Kuehni, Claudia E. Teepen, Jop C. Øfstaas, Hilde Loonen, Jaqueline Dudley, Isabelle M. Hawkins, Michael M. |
| AuthorAffiliation | 6 Department of Pediatrics and Adolescent Medicine Johannes Kepler University Linz Kepler University Hospital Linz Austria 1 Center for Childhood Cancer Survivor Studies Institute of Applied Health Research University of Birmingham Birmingham UK 16 University Children's Hospital Ljubljana University Medical Center Ljubljana Ljubljana Slovenia 26 Division of Radiotherapy Institute of Oncology Ljubljana Slovenia 29 Emma Children's Hospital Amsterdam Netherlands 18 Department of Clinical Sciences Lund, Pediatrics Lund University Skane University Hospital Lund Sweden 2 Princess Maxima Center for Pediatric Oncology Utrecht The Netherlands 24 Department of Registration Cancer Registry of Norway Oslo Norway 19 Childhood Cancer Registry of Piedmont Cancer Epidemiology Unit Department of Medical Sciences University of Turin Turin Italy 30 Department of Pediatrics and Adolescent Medicine Turku University and Turku University Hospital Turku Finland 17 Department of Hematology Radboud University Medical Cen |
| AuthorAffiliation_xml | – name: 6 Department of Pediatrics and Adolescent Medicine Johannes Kepler University Linz Kepler University Hospital Linz Austria – name: 2 Princess Maxima Center for Pediatric Oncology Utrecht The Netherlands – name: 25 Pediatric Oncology Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy – name: 31 Department of Clinical Medicine Faculty of Health Aarhus University and University Hospital Aarhus Denmark – name: 22 German Childhood Cancer Registry Division of Childhood Cancer Epidemiology Institute of Medical Biostatistics, Epidemiology, and Informatics Johannes‐Gutenberg University Mainz Mainz Germany – name: 13 Boyne Research Institute Bettystown Co Meath Ireland – name: 20 Reference Center for Epidemiology and Cancer Prevention‐Piemonte University Hospital Citta della Salute e della Scienza di Torino Turin Italy – name: 29 Emma Children's Hospital Amsterdam Netherlands – name: 21 Radiation Epidemiology Team Center for Research in Epidemiology and Population Health National Institute of Health and Medical Research Unit 1018 University Paris Saclay Gustave Roussy Villejuif France – name: 7 Scientific Directorate IRCCS Istituto Giannina Gaslini Genova Italy – name: 4 Center for Primary Care and Public Health (Unisante) University of Lausanne Lausanne Switzerland – name: 26 Division of Radiotherapy Institute of Oncology Ljubljana Slovenia – name: 5 St Anna Children's Hospital Vienna Austria – name: 16 University Children's Hospital Ljubljana University Medical Center Ljubljana Ljubljana Slovenia – name: 27 Division of Pediatric Hematology/Oncology Department of Pediatrics University Children's Hospital of Bern University of Bern Bern Switzerland – name: 14 Division of Pediatric and Adolescent Medicine Oslo University Hospital Rikshospitalet Oslo Norway – name: 17 Department of Hematology Radboud University Medical Center Nijmegen Netherlands – name: 3 Childhood Cancer Research Group Institute of Social and Preventive Medicine University of Bern Bern Switzerland – name: 8 Danish Cancer Society Research Center Childhood Cancer Research Group Copenhagen Denmark – name: 11 Newcastle University Center for Cancer Newcastle University Newcastle upon Tyne UK – name: 19 Childhood Cancer Registry of Piedmont Cancer Epidemiology Unit Department of Medical Sciences University of Turin Turin Italy – name: 24 Department of Registration Cancer Registry of Norway Oslo Norway – name: 23 Hungarian Childhood Cancer Registry Second Department of Pediatrics Semmelweis University Budapest Hungary – name: 30 Department of Pediatrics and Adolescent Medicine Turku University and Turku University Hospital Turku Finland – name: 15 Pediatric Clinic University of Milano‐Bicocca Hospital San Gerardo Monza Italy – name: 18 Department of Clinical Sciences Lund, Pediatrics Lund University Skane University Hospital Lund Sweden – name: 28 Diagnosis, Observation, Prevention After Oncologic Treatment (DOPO) Clinic Division of Hematology/Oncology IRCCS Istituto Giannina Gaslini Genova Italy – name: 12 Department of Health Sciences and Medicine University of Lucerne Lucerne Switzerland – name: 9 Children's Hospital Landspitali University Hospital Reykjavik Iceland – name: 10 Great North Children's Hospital Newcastle upon Tyne Hospitals National Health Service Foundation Trust Newcastle upon Tyne UK – name: 1 Center for Childhood Cancer Survivor Studies Institute of Applied Health Research University of Birmingham Birmingham UK |
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| CitedBy_id | crossref_primary_10_1016_j_ijrobp_2024_01_206 |
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| DOI | 10.1002/cncr.34561 |
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| Keywords | subsequent primary lymphoma non-Hodgkin lymphoma childhood cancer survivors second cancers late effects Hodgkin lymphoma |
| Language | English |
| License | Attribution-NonCommercial 2022 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society. Attribution: http://creativecommons.org/licenses/by This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
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| Notes | Coauthor Stanislaw Garwicz MD died November 27, 2018. This work is dedicated to him. PMCID: PMC10099796 |
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Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent... Survivors of Hodgkin lymphoma (HL) are at risk of developing non-Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent primary... Abstract Background Survivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing... BackgroundSurvivors of Hodgkin lymphoma (HL) are at risk of developing non‐Hodgkin lymphoma (NHL) after treatment; however, the risks of developing subsequent... Background: Survivors of Hodgkin lymphoma (HL) are at risk of developing non-Hodgkin lymphoma (NHL) after treatment; however, the risks of developing... Using data from 69,460 five‐year survivors of childhood cancer across Europe, the authors investigated the risks of subsequent primary lymphoma within the... |
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| SubjectTerms | Adolescent Adolescents Bone cancer Bone Neoplasms - complications Bone tumors Cancer Cancer and Oncology Cancer och onkologi Chemotherapy childhood cancer survivors Children Clinical Medicine Confidence intervals Europe - epidemiology Hodgkin Disease - complications Hodgkin Disease - epidemiology Hodgkin lymphoma Humans Incidence Kidney Neoplasms - complications Klinisk medicin late effects Leukemia Leukemia - epidemiology Life Sciences Lymphoma Lymphoma - complications Lymphoma - epidemiology Lymphoma, Non-Hodgkin - therapy Medical and Health Sciences Medicin och hälsovetenskap Neoplasms, Second Primary - epidemiology Neoplasms, Second Primary - etiology non-Hodgkin lymphoma Non-Hodgkin's lymphoma Oncology Original Osteosarcoma Radiation therapy Risk Risk assessment Risk Factors Sarcoma Sarcoma - epidemiology second cancers Statistical analysis subsequent primary lymphoma Survival Survivors Teenagers Tumors Wilms Tumor - complications |
| Title | 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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