ABSENCE OF TREATMENT-INDUCED 2ND NEOPLASMS AFTER ABVD IN HODGKINS-DISEASE

  • 1 January 1982
    • journal article
    • research article
    • Vol. 59  (3) , 488-494
Abstract
One of the most serious complications of successful treatments for Hodgkin''s disease is an increased incidence of acute nonlymphocytic leukemia (ANLL) and other malignancies. A retrospective analysis carried out on 1032 consecutive patients with Hodgkin''s disease admitted between 1965-1978 and treated with radiotherapy (RT) or chemotherapy or both modalities revealed that within 10 yr from initial therapy, ANLL was documented in 3% of the patients; over a comparable period of time, 7.9% of patients developed other malignancies. ANLL was observed only in patients treated with chemotherapeutic regimens containing alkylating agents and/or procarbazine alone (2.3%) or associated with RT (4%). Other 2nd tumors were documented in patients given RT with or without chemotherapy. No 2nd malignancies were observed in patients given ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) with or without RT. The incidence of ANLL was higher in patients given chemotherapy as salvage treatment upon relapse following primary irradiation (6.1%) compared to patients initially treated with combined modality (1.5%). The difference failed to reach statistical significance. Since this analysis supports the evidence of a major role played by alkylating agents, procarbazine and RT in inducing 2nd malignancies, regimens not containing these drugs or their administration through treatments of different intensity warrant careful consideration.