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Blood, 15 April 2008, Vol. 111, No. 8, pp. 4014-4021. Prepublished online as a Blood First Edition Paper on February 7, 2008; DOI 10.1182/blood-2007-08-106021. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-08-106021v1 111/8/4014    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Bluhm, E. C. Articles by Inskip, P. D. PubMed PubMed Citation Articles by Bluhm, E. C. Articles by Inskip, P. D. Related Collections Clinical Trials and Observations Neoplasia Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Cause-specific mortality and second cancer incidence after non-Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study Elizabeth C. Bluhm1, Cécile Ronckers1,2, Robert J. Hayashi3, Joseph P. Neglia4, Ann C. Mertens5, Marilyn Stovall6, Anna T. Meadows7, Pauline A. Mitby4, John A. Whitton8, Sue Hammond9, Joseph D. Barker10, Sarah S. Donaldson11, Leslie L. Robison12, and Peter D. Inskip1 1 Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD; 2 Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands; 3 Division of Pediatric Hematology and Oncology, Washington University School of Medicine, St Louis, MO; 4 Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis; 5 Aflac Cancer Center and Blood Disorders Service, Emory Children's Center, Atlanta, GA; 6 University of Texas M. D. Anderson Cancer Center, Houston; 7 Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine; 8 Fred Hutchinson Cancer Research Center, Seattle, WA; 9 Department of Pathology, Ohio State University School of Medicine, Columbus; 10 IMS Management Systems, Silver Spring, MD; 11 Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA; and 12 Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN Second primary malignancies and premature death are a concern for patients surviving treatment for childhood lymphomas. We assessed mortality and second malignant neoplasms (SMNs) among 1082 5-year survivors of non-Hodgkin lymphoma (NHL) in the Childhood Cancer Survivor Study, a multi-institutional North American retrospective cohort study of cancer survivors diagnosed from 1970 to 1986. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated using US population rates. Relative risks for death and solid tumor SMNs were calculated based on demographic, clinical, and treatment characteristics using Poisson regression models. There were 87 observed deaths (SMR = 4.2; 95% CI, 1.8-4.1) with elevated rates of death from solid tumors, leukemia, cardiac disease, and pneumonia. Risk for death remained elevated beyond 20 years after NHL. Risk factors for death from causes other than NHL included female sex (rate ratio [RR] = 3.4) and cardiac radiation therapy exposure (RR = 1.9). There were 27 solid tumor SMNs (SIR = 3.9; 95% CI, 2.6-5.7) with 3% cumulative incidence between 5 and 20 years after NHL diagnosis. Risk factors were female sex (RR = 3.1), mediastinal NHL disease (RR = 5.2), and breast irradiation (RR = 4.3). Survivors of childhood NHL, particularly those treated with chest RT, are at continued increased risk of early mortality and solid tumor SMNs. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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