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Risk for second malignancies in non-Hodgkin's lymphoma survivors: a meta-analysis
M Pirani1, R Marcheselli, L Marcheselli
1Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
Summary
Non-Hodgkin's lymphoma (NHL) survivors face an increased risk of secondary malignant neoplasms (SMNs). Treatments like chemotherapy and combined therapies significantly elevate this risk, necessitating further research into contributing factors.
Area of Science:
- Oncology
- Cancer Epidemiology
- Clinical Research
Background:
- Late side-effects are a growing concern for non-Hodgkin's lymphoma (NHL) survivors.
- Secondary malignant neoplasms (SMNs) represent a significant long-term risk in this population.
Purpose of the Study:
- To estimate the pooled relative risk (RR) of SMNs in NHL survivors.
- To evaluate site-specific RR and the influence of different treatment modalities on SMN development.
Main Methods:
- Systematic electronic literature search of Medline and EMBASE databases.
- Meta-analysis of 23 eligible studies using fixed- and random-effects models.
- Assessment of study heterogeneity and publication bias.
Main Results:
- A pooled RR of 1.88 for overall SMNs and 1.32 for solid tumors was observed.
- Chemotherapy and combined treatments, unlike radiotherapy alone, significantly increased SMN risk.
- Total body irradiation and younger age at diagnosis were associated with higher SMN risk.
Conclusions:
- NHL survivors exhibit a substantially higher risk of SMNs compared to the general population.
- Treatment modalities differentially impact the risk of developing SMNs.
- Further investigation is needed to understand interactions with genetic and environmental factors.
