title: Acute myeloid leukemia following Hodgkin lymphoma: a population-based study of 35,511 patients.
abstract: Treatments for Hodgkin lymphoma are associated with large relative risks of acute myeloid leukemia (AML), but there are few estimates of the excess absolute risk (EAR), a useful measure of disease burden. One-year Hodgkin lymphoma survivors (N = 35,511) were identified within 14 population-based cancer registries in Nordic countries and North America from January 1, 1970, through December 31, 2001. We used Poisson regression analysis to model the EAR of AML, per 10,000 person-years. A total of 217 Hodgkin lymphoma survivors were diagnosed with AML (10.8 expected; unadjusted EAR = 6.2; 95% confidence interval = 5.4 to 7.1). Excess absolute risk for AML was highest during the first 10 years after Hodgkin lymphoma diagnosis but remained elevated thereafter. In subsequent analyses, adjusted for time since Hodgkin lymphoma diagnosis and presented for the 5-9 year interval, the EAR was statistically significantly (P < .001) larger in patients diagnosed with Hodgkin lymphoma at age 35 years and older than in those diagnosed before 35 years of age. The EAR of AML declined statistically significantly after 1984 (7.0 to 4.2 and 16.4 to 9.9 in the < 35 and > or = 35 age groups, respectively), which may be associated with modifications in chemotherapy.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-7238, USA.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Schonfeld
authors.forename: Ethel S
authors.initials: ES
authors.lastname: Gilbert
authors.forename: Graça M
authors.initials: GM
authors.lastname: Dores
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.forename: David C
authors.initials: DC
authors.lastname: Hodgson
authors.forename: Per
authors.initials: P
authors.lastname: Hall
authors.forename: Hans
authors.initials: H
authors.lastname: Storm
authors.forename: Aage
authors.initials: A
authors.lastname: Andersen
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.forename: Eric
authors.initials: E
authors.lastname: Holowaty
authors.forename: Magnus
authors.initials: M
authors.lastname: Kaijser
authors.forename: Michael
authors.initials: M
authors.lastname: Andersson
authors.forename: Heikki
authors.initials: H
authors.lastname: Joensuu
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: James M
authors.initials: JM
authors.lastname: Allan
authors.forename: Lois B
authors.initials: LB
authors.lastname: Travis
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005387:Finland / Q000453:epidemiology; D006689:Hodgkin Disease / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000453:epidemiology*; D009656:North America / Q000453:epidemiology; D009864:Ontario / Q000453:epidemiology; D016012:Poisson Distribution; D012042:Registries; D012107:Research Design; D018570:Risk Assessment; D018426:SEER Program; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents