Non-Hodgkin's lymphomas following radiation therapy alone for Hodgkin's disease

We have recently treated three patients who developed a non-Hodgkin's lymphoma after therapy with radiation alone for Hodgkin's disease. The secondary non-Hodgkin's lymphomas occurred 4 years (two patients) and 11.5 years after receiving irradiation. Thirteen additional cases have been reported and are reviewed with attention to the subsequent histology and response to treatment of these secondary non-Hodgkin's lymphomas. The pathogenesis is unknown, but, may be therapy-related or part of the natural history of the lymphocyte predominance subtype of Hodgkin's disease. Possible mechanisms will be discussed. A subset of the patients with secondary lymphomas following radiation therapy alone are curable with chemotherapy. New sites of disease after apparent control of Hodgkin's disease require pathology for confirmation of the disease process and appropriate therapy.