PDF(Pubmed)
Abstract：
OBJECTIVE: Survivors after pediatric Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are with lifetime risk for second primary malignancy (SPM). This necessitates a thorough analysis to better understand the potential long-term health implications for these individuals.
METHODS: We used a US-wide population-based cancer registry data to quantify the SPM risk and identify its incidence patterns among pediatric lymphoma patients.
RESULTS: We observed 4.74-fold (95% CI 4.27-5.25) and 3.40-fold (95% CI 2.78-4.10) increased risks of SPM in survivors after pediatric HL and NHL, respectively. Through over 40 years\' follow-up, the cumulative incidence of SPM for pediatric lymphoma was persistently increasing, and here we firstly report the high 40-year cumulative incidence rates of SPM, 22.2% for HL and 12.6% for NHL, suggesting that SPM accounts for a great proportion of deaths among survivors. Of 6805 pediatric lymphomas, 462 (6.36%) developed a SPM, especially second breast and thyroid cancer, followed by hematologic neoplasms including leukemia and NHL. The competing risk analysis demonstrated gender, lymphoma subtype and radiotherapy were significantly associated with SPM. Different risk patterns of SPM were identified between pediatric HL and NHL. Chemotherapy accelerated SPM development but did not increase its incidence risk.
CONCLUSIONS: Overall, patients after pediatric lymphoma can be with high lifetime risk of SPM, and more attention should be paid to SPM-related signs for early detection and intervention.
METHODS: We used a US-wide population-based cancer registry data to quantify the SPM risk and identify its incidence patterns among pediatric lymphoma patients.
RESULTS: We observed 4.74-fold (95% CI 4.27-5.25) and 3.40-fold (95% CI 2.78-4.10) increased risks of SPM in survivors after pediatric HL and NHL, respectively. Through over 40 years\' follow-up, the cumulative incidence of SPM for pediatric lymphoma was persistently increasing, and here we firstly report the high 40-year cumulative incidence rates of SPM, 22.2% for HL and 12.6% for NHL, suggesting that SPM accounts for a great proportion of deaths among survivors. Of 6805 pediatric lymphomas, 462 (6.36%) developed a SPM, especially second breast and thyroid cancer, followed by hematologic neoplasms including leukemia and NHL. The competing risk analysis demonstrated gender, lymphoma subtype and radiotherapy were significantly associated with SPM. Different risk patterns of SPM were identified between pediatric HL and NHL. Chemotherapy accelerated SPM development but did not increase its incidence risk.
CONCLUSIONS: Overall, patients after pediatric lymphoma can be with high lifetime risk of SPM, and more attention should be paid to SPM-related signs for early detection and intervention.
摘要：
目的：小儿霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）后的幸存者具有第二原发性恶性肿瘤（SPM）的终生风险。这需要进行彻底的分析，以更好地了解这些人的潜在长期健康影响。
方法：我们使用了美国范围内基于人群的癌症登记数据来量化SPM风险并确定其在小儿淋巴瘤患者中的发病率模式。
结果：我们观察到儿童HL和NHL后幸存者SPM的风险增加了4.74倍（95％CI4.27-5.25）和3.40倍（95％CI2.78-4.10），分别。经过40多年的随访，儿童淋巴瘤的SPM累积发病率持续增加，在这里，我们首先报告了SPM的高40年累积发病率，HL为22.2%，NHL为12.6%，表明SPM占幸存者死亡的很大比例。在6805例小儿淋巴瘤中，462（6.36%）制定了SPM，尤其是第二乳腺癌和甲状腺癌，其次是血液肿瘤，包括白血病和NHL。竞争风险分析表明性别，淋巴瘤亚型和放疗与SPM显著相关。在小儿HL和NHL之间确定了不同的SPM风险模式。化疗加速了SPM的发展，但没有增加其发生风险。
结论：总体而言，小儿淋巴瘤后的患者可能有很高的SPM终生风险，应重视SPM相关体征的早期发现和干预。
方法：我们使用了美国范围内基于人群的癌症登记数据来量化SPM风险并确定其在小儿淋巴瘤患者中的发病率模式。
结果：我们观察到儿童HL和NHL后幸存者SPM的风险增加了4.74倍（95％CI4.27-5.25）和3.40倍（95％CI2.78-4.10），分别。经过40多年的随访，儿童淋巴瘤的SPM累积发病率持续增加，在这里，我们首先报告了SPM的高40年累积发病率，HL为22.2%，NHL为12.6%，表明SPM占幸存者死亡的很大比例。在6805例小儿淋巴瘤中，462（6.36%）制定了SPM，尤其是第二乳腺癌和甲状腺癌，其次是血液肿瘤，包括白血病和NHL。竞争风险分析表明性别，淋巴瘤亚型和放疗与SPM显著相关。在小儿HL和NHL之间确定了不同的SPM风险模式。化疗加速了SPM的发展，但没有增加其发生风险。
结论：总体而言，小儿淋巴瘤后的患者可能有很高的SPM终生风险，应重视SPM相关体征的早期发现和干预。
