Non-Hodgkin lymphoma secondary to cancer chemotherapy

Increased long-term survival seen in patients with solid and hematologic cancers achieved as a result of aggressive chemoradiotherapy has come at a price. Therapy-related acute myeloid leukemia has been frequently documented in these patient cohorts, and its biology well studied. Recognition of secondary non-Hodgkin lymphoma as a cause of significant morbidity and mortality in these patients is equally important. The patterns of incidence and latency of secondary lymphomas is distinct from that of myeloid malignancies and other solid cancers. We have systematically analyzed and summarized reports from various groups over the last three decades. Risk of secondary lymphomas increases after the first 5 years of completion of chemotherapy or radiotherapy and persists for more than three decades. This reinforces the need for long-term follow-up of all patients exposed to chemoradiotherapy and confirms that chemotherapeutic agents can cause lymphoma.