Acute myeloid leukemia following Hodgkin lymphoma: a population-based study of 35,511 patients.
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.
Schonfeld
Sara J
SJ
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-7238, USA.
Gilbert
Ethel S
ES
Dores
Graça M
GM
Lynch
Charles F
CF
Hodgson
David C
DC
Hall
Per
P
Storm
Hans
H
Andersen
Aage
A
Pukkala
Eero
E
Holowaty
Eric
E
Kaijser
Magnus
M
Andersson
Michael
M
Joensuu
Heikki
H
Fosså
Sophie D
SD
Allan
James M
JM
Travis
Lois B
LB
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
D000970:Antineoplastic Agents