From the Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.
Author's disclosure of potential conflicts of interest is found at the end of this article.
Address reprint requests to Andrea K. Ng, MD, MPH, Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, 75 Francis Street, ASB1-L2, Boston, MA 02115; e-mail: ang{at}lroc.harvard.edu
Overview: Second malignancy has been shown to be the leading cause of death of long-term survivors of Hodgkin's lymphoma. The three main types of second cancers in these patients are leukemia, non-Hodgkin's lymphoma, and solid tumors. Solid tumors, which typically develop after a long latency, currently account for more than three-quarters of all cases of second malignancies. The three most common solid tumors after Hodgkin's lymphoma are breast cancer, lung cancer, and gastrointestinal cancer. Different types of second malignancies vary in their relationship with Hodgkin's lymphoma treatment history, association with other modifying risk factors, and overall prognosis. Studies characterizing the timing of and risk factors for various second malignancies can provide useful information in the development of follow-up programs that are aimed at reducing the negative effect of second malignancy on the life expectancy of long-term survivors of Hodgkin's lymphoma. These include screening, risk reduction, and prevention interventions. Our knowledge on second malignancy risks and other late effects have in part motivated the considerable changes in the treatment for Hodgkin's lymphoma over the years. As treatment for the disease evolves with time, continued follow-up and careful documentation of the efficacy, as well as of complications associated with the newer treatment, will be essential.
