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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 (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 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 HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bluhm, E. C Articles by Inskip, P. D Search for Related Content PubMed PubMed Citation Articles by Bluhm, E. C Articles by Inskip, P. D Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 10, 2007 Accepted January 25, 2008 Cause-specific mortality and second cancer incidence after non-Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study Elizabeth C Bluhm*, Cecile Ronckers, Robert J Hayashi, Joseph P Neglia, Ann C Mertens, Marilyn Stovall, Anna T Meadows, Pauline A Mitby, John A Whitton, Sue Hammond, Joseph D Barker, Sarah S Donaldson, Leslie L. Robison, and Peter D Inskip Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, United States Department of Pediatric Oncology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands Divison of Pediatric Hematology and Oncology, Washington University School of Medicine, St. Louis, MO, United States Division of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, United States Aflac Cancer Center and Blood Disorders Service, Emory Children's Center, Atlanta, GA, United States The University of Texas M.D. Anderson Cancer Center, Houston, TX, United States Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, United States Fred Hutchinson Cancer Research Center, Seattle, WA, United States Department of Pathology, Ohio State University School of Medicine, Columbus, OH, United States IMS Management Systems, Silver Spring, MD, United States Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA, United States Department of Epidemiology and Cancer Control, Saint Jude Children's Research Hospital, Memphis, TN, United States * Corresponding author; email: bluhme{at}mail.nih.gov. 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 1,082 five-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 during 1970-1986. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated using United States 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 (RR=3.4) and cardiac radiation therapy (RT) 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? This article has been cited by other articles: G. T. Armstrong, Q. Liu, Y. Yasui, S. Huang, K. K. Ness, W. Leisenring, M. M. Hudson, S. S. Donaldson, A. A. King, M. Stovall, et al. Long-Term Outcomes Among Adult Survivors of Childhood Central Nervous System Malignancies in the Childhood Cancer Survivor Study J Natl Cancer Inst, July 1, 2009; 101(13): 946 - 958. [Abstract] [Full Text] [PDF] A. T. Meadows, D. L. Friedman, J. P. Neglia, A. C. Mertens, S. S. Donaldson, M. Stovall, S. Hammond, Y. Yasui, and P. D. Inskip Second Neoplasms in Survivors of Childhood Cancer: Findings From the Childhood Cancer Survivor Study Cohort J. Clin. Oncol., May 10, 2009; 27(14): 2356 - 2362. [Abstract] [Full Text] [PDF] G. T. Armstrong, Q. Liu, Y. Yasui, J. P. Neglia, W. Leisenring, L. L. Robison, and A. C. Mertens Late Mortality Among 5-Year Survivors of Childhood Cancer: A Summary From the Childhood Cancer Survivor Study J. Clin. Oncol., May 10, 2009; 27(14): 2328 - 2338. [Abstract] [Full Text] [PDF] L. Diller, E. J. Chow, J. G. Gurney, M. M. Hudson, N. S. Kadin-Lottick, T. I. Kawashima, W. M. Leisenring, L. R. Meacham, A. C. Mertens, D. A. Mulrooney, et al. Chronic Disease in the Childhood Cancer Survivor Study Cohort: A Review of Published Findings J. Clin. Oncol., May 10, 2009; 27(14): 2339 - 2355. [Full Text] [PDF] L. L. Robison, G. T. Armstrong, J. D. Boice, E. J. Chow, S. M. Davies, S. S. Donaldson, D. M. Green, S. Hammond, A. T. Meadows, A. C. Mertens, et al. The Childhood Cancer Survivor Study: A National Cancer Institute-Supported Resource for Outcome and Intervention Research J. Clin. Oncol., May 10, 2009; 27(14): 2308 - 2318. [Abstract] [Full Text] [PDF]

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