The risk of a second malignancy was analyzed in 23 patients with Hodgkin's disease (HD) and 177 with non-Hodgkin's lymphoma (NHL) who were initially treated with combination chemotherapy between 1976 and 1990. Among these patients, 3 cases of gastric cancer, 2 cases of lung cancer, 2 cases of hepatoma, one case of colon cnacer, one case of cholangiocarcinoma and one case of acute myeloblastic leukemia were subsequently observed. Median age at diagnosis of lymphoma was 64 years in patients who developed subsequent malignancies but was 9 years higher than that for the entire lymphoma group. Median interval from srart of chemotherapy to the appearance of second malignancy was 43.9 years and ranged from 1.9 years to 8.8 years. The 7-year cumulative risk of second malignancy in HD and NHL were 7.7% and 11.7%, respectively. In Hodgkin's disease, the incidence of stomach and lung cancers was significantly greater than expected incidence calculated on the basis of age-adjusted person-years. In non-Hodgkin's lymphoma, the incidence was also greater than expected for all malignancies except stomach cancer. This indicater that the incidence of solid malignancy as well as leukemia is higher in lymphoma patients after chemotherapy than in the general population.
second primary malignancy