Secondary Myeloid Leukemia and MDS in Patients Treated for Hodgkin Lymphoma - Experience of the German Hodgkin Lymphoma Study Group (GHSG)

Depending on age and risk fac tors, more than 80% of patients with Hodgkin Lymphoma (HL) are currently being cured. 1 Long-term survivors, however, are at risk for treat ment-related complications such as infertility, cardiac or pulmonary dys function or thyroid-related sequelae. Increased risk of secondary cancers has been observed after chemo- and radio therapy. The malignancies most fre quently associated with chemotherapy include acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). 2-5 Treatment-related AML and MDS generally respond poorly to therapy. Currently, there is no clear treatment strategy for secondary AML/MDS after HL, at least in part due to scarce data. Curative treatment strategies in second malignancies after HL are not yet stan dardized. Controversy exists about the value of hematopoietic stem cell trans plantation. High-dose chemotherapy (HDCT) with allogeneic stem cell transplantation (ASCT) has been attempted resulting in some respons es. 7-9 However, review of the literature reveals little information about the long-term clinical outcome of treat ment-related AML or MDS after treat ment for HL. Therefore, we retrospectively ana lyzed patients with secondary AML/ MDS registered in the database of the German Hodgkin’s Lymphoma Study Group (GHSG) in a total of 5411 patients.10 The purpose of the present analysis is to determine incidence and treatment outcome in particular in respect to long-term results.