[Second malignant disease in patients under treatment for malignant lymphoma]

Between 1978 and 1993, 1013 patients 529 with Hodgkin's disease and 484 with non-Hodgkin's lymphomas--were treated in our department. Out of 1013 patients secondary neoplasms developed in 23 cases: 3 acute nonlymphocytic leukemia, 19 solid tumors and 1 secondary non-Hodgkin's lymphoma. The median time from diagnosis of malignant lymphoma was 7 years and their median age was 49 years. 11 patients with secondary tumor were treated with chemotherapy and 12 received combined (radio- and chemo-) therapy. Since alkylating agents increase the risk of leukemia and radiation contributes mainly to other cancer, future treatment protocols should attempt to reduce the most serious consequences of therapy without compromising the survival. Careful lifelong observation is indicated for patients with malignant lymphomas, with special attention given to new clinical signs or symptoms.