Hodgkin Lymphoma as Second Malignancy during Continuing Chemotherapy for Childhood Acute Lymphoblastic Leukemia

Abstract

Acute lymphoblastic leukemia (ALL) is the most prevalent childhood malignancy in most parts of the world with a 5-year survival rate above 70%. Long-term survivors are at risk for treatment-related late effects and second malignant neoplasms (SMNs). SMNs occur with a mean latency of 6–6.7 years after ALL diagnosis but are rarely observed during maintenance chemotherapy (CT). Hodgkin lymphoma (HL) as a complication of ALL is very rare. We report two children with ALL who developed HL while receiving maintenance CT. Both received appropriate chemo- and radiotherapy (CT/RT) and have survived for more than10 years.

Zusammenfassung

Die akute lymphatische Leukämie (ALL) ist die häufigste maligne Erkrankung bei Kindern und kann bei adäquater Therapie in >70% in eine Langzeitremission gelangen. Bei Langzeitüberlebenden besteht das Risiko für Spätfolgen und maligne Zweitneoplasien (SMNs). SMNs treten nach einer mittleren Latenzzeit von 6–6,7 Jahren auf und werden selten während der Dauertherapie einer ALL beobachtet. Ein Hodgkin-Lymphom (HL) als Komplikation einer ALL ist sehr selten. Wir berichten von zwei Kindern mit ALL, bei denen während der Dauertherapie ein HL auftrat. Beide erhielten eine protokollgemäße Chemo- und Strahlentherapie (CT/RT) und überleben beide Erkrankungen schon mehr als 10 Jahre.

acute lymphoblastic leukemia - Hodgkin lymphoma - second malignancy

akute lymphatische Leukämie - Hodgkin-Lymphom - Zweitmalignom

Literatur

• 1 Bhatia S, Sather HN, Pabustan OB. et al . Low incidence of second neoplasms among children diagnosed with acute lymphoblastic leukemia after 1983.  Blood. 2002;  99 4257-4264
• 2 Borgmann A, Zinn C, Hartmann R. et al . Secondary malignant neoplasms after intensive treatment of relapsed acute lymphoblastic leukaemia in childhood.  Eur J Cancer. 2008;  44 257-268
• 3 Calaminus G, Kaatsch P. Position paper of the Society of Pediatric Oncology and Hematology (GPOH) on (long-term surveillance (long-term) follow-up and late effect evaluation in pediatric oncology patients.  Klin Pädiatr. 2007;  219 173-178
• 4 Garwicz S, Aronson S, Andreasson B. et al . Hodgkin's disease occurring acute leukaemia in remission.  Lancet. 1978;  1 269
• 5 Haas RJ, Janka G, Gaedicke G. et al . Therapy of acute lymphoblastic leukemia in children with intermediate dose methotrexate.  Blut.. 1983;  47 1-11
• 6 Hagmann R, Neef V, Treuner J. et al . Unusual course of morbus Hodgkin during remission of acute lymphatic leukemia.  Monatsschr Kinderheilkd. 1981;  129 110-114
• 7 Horbar JD, Dickermann JD, Allen EF. et al . Hodgkin's Disease following acute lymphocytic leukemia in a patient from cancer-prone family: a case report.  Med Pediatr Oncol. 1981;  9 219-223
• 8 Kim HS, Roh HO, Kang SH. et al . Hodgkin's disease in a child with acute lymphoblastic leukemia.  Yonsei Med J. 1991;  32 270-274
• 9 Kimball Dalton VM, Gelber RD, Li F. et al . Second malignancies in patients treated for childhood acute lymphoblastic leukemia.  J Clin Oncol. 1998;  16 2848-2853
• 10 Kortmann R-D, Bongartz R, Dieckmann K. et al . Requirements and performance profile of the Pediatric Radiation Oncology Working Group (APRO): Evaluation of the present situation and description of future developments.  Klin Pädiatr. 2007;  219 166-172
• 11 Labotka RJ, Sotelo-Avila C, Hruby MA. Hodgkin's disease in a child with lymphoblastic leukemia.  Cancer. 1983;  52 846-850
• 12 Lampert F, Boosen K. Hodgkin's disease during remission of acute lymphoblastic leukemia.  Klin Pädiatr. 1977;  189 292-294
• 13 Loning L, Zimmermann M, Reiter A. et al . Secondary neoplasmas subsequent to Berlin-Frankfurt-Munster therapy of acute lymphoblastic leukemia in childhood: significantly lower risk without cranial radiotherapy.  Blood. 2000;  95 2770-2775
• 14 Mosijczuk AD, Ruymann FB. Second malignancy in acute lymphocyte leukemia, Review of 33 cases.  Am J Dis Child. 1981;  135 313-316
• 15 Neglia JP, Meadows AT, Robinson LL. et al . Second neoplasms after acute lymphoblastic leukemia in childhood.  N Engl J Med. 1991;  325 1330-1336
• 16 Nygaars R, Garwicz S, Haldorsen T. et al . Second malignant neoplasms in patients treated for childhood leukemia. A population-based cohort study from the Nordic countries.  The Nordic Society of Pediatric Oncology and Hematology (NOPHO). Acta Paediatr Scand. 1991;  80 1220-1228
• 17 Peeters MA, Smith C, Saunders EF. Secondary Hodgkin's disease in childhood acute lymphoblastic leukemia.  Med Pediatr Oncol. 1986;  14 230-233
• 18 Ragusa R, Russo S, Villari L. et al . Hodgkin's disease as a second malignant neoplasm in childhood: report of a case and review of the literature.  Pediatr Hemtol Oncol. 2001;  18 407-414
• 19 Rosner F, Grunwald H. Hodgkin's Disease and Acute Leukemia: Report of Eight Cases and Review of the Literature.  Am J Med. 1975;  58 339-353
• 20 Sabatino D, Hameed N, Kulpa J. et al . Hodgkin's disease in a child with acute lymphocytic leukemia in remission.  Am J Pediatr Hematol Oncol. 1986;  8 73-75
• 21 Wingen AM, Olischlager A, Kleihauer E. Morbus Hodgkin as a second malignancy in acute lymphoblastic leukaemia.  Klin Pädiatr. 1979;  191 1-7
• 22 Woodruff RK, Lister TA, Brearley RL. et al . Hodgkin's disease occurring during acute leukaemia in remission.  Lancet. 1977;  2 900-903

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