Risk of subsequent primary lymphoma among five-year survivors of childhood and adolescent cancer in Europe

Survivors of Hodgkin lymphoma (HL) are at risk of developing non-Hodgkin lymphoma (NHL), but risks of developing subsequent primary lymphomas (SPLs) after different types of childhood cancer are unknown. The PanCareSurFup trial included five-year survivors of childhood and adolescent cancer in twelve European countries and analyzed the cumulative incidence of developing SPLs. Compared with the general population, survivors were at 60% increased risk of an SPL (SIR 1.6; 95% CI 1.4-1.9). Survivors were twice as likely to develop NHL (SIR 2.3; 95% CI 1.9-2.8), with the greatest risks among survivors of HL (7.1; 5.1-10.0), Wilms tumor (3.1; 1.7-5.7), leukemia (2.8; 1.8-4.4), and bone sarcoma (2.7; 1.4-5.4). Chemotherapy, but not radiotherapy, was associated with elevated risk of NHL. The risk of developing a subsequent HL was not elevated in survivors compared with the general population.