Study Examines Second Cancer Risk Among Hairy Cell Leukemia Survivors

Survivors of a rare cancer called hairy cell leukemia are at an increased risk of Hodgkin lymphoma, non-Hodgkin lymphoma, and thyroid cancer, and at an increased risk of death from leukemia and lymphoma, according to a new study. However, the absolute risk of those second cancers is small.

Hairy cell leukemia is a malignancy of a type of white blood cell called B lymphocytes. It accounts for about 2 percent of all leukemias. Better treatments have improved the prognosis for this disease, but the treatments may be associated with an increased risk of second cancers. To determine the risk of second cancers and to examine the causes of death among these patients, Michie Hisada, M.D., Sc.D., and colleagues at the National Cancer Institute examined the records for 3,104 patients with hairy cell leukemia who survived for at least two months after diagnosis.

They found that hairy cell leukemia survivors had a 6.6-fold increased risk of Hodgkin lymphoma, a 5-fold increased risk of non-Hodgkin lymphoma, a 3.6-fold increased risk of thyroid cancer, but a decreased risk of lung cancer compared with the general population. Among survivors, there was a lower risk of death from cardiovascular and cerebrovascular diseases than among the general population. "… Extrapolating from our results, among 10,000 hairy cell leukemia patients, a total excess of about 34 cancers - 21 non-Hodgkin lymphomas, 2 Hodgkin lymphomas, and 7 solid tumors (including two thyroid cancers) - might be observed per year," the authors write.

"Future studies should address the influence of such factors as changes in treatment regimens, immunologic impairment, natural history, diagnostic misclassification, and tobacco use on risk of second cancers in hairy cell leukemia patients," the authors conclude.

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Other highlights in the February 7 JNCI

Contact: Liz Savage
Journal of the National Cancer Institute