Acute myelogenous leukemia as a second malignant neoplasm following the successful treatment of advanced Hodgkin's disease.
Of 209 Hodgkin's disease patients treated at least 6 months with a five-drug combination of induction chemotherapy and having a complete remission, four patients developed acute myelogenous leukemia (AML) as a second malignant neoplasm. The overall relative risk for development of AML is 185.0 (P less than 0.05) and the mean time to occurrence of AML is 5.3 years (median, 5.25 years). When examining patient subgroups, the highest relative risk noted was 338.5 (P less than 0.05) for that group of patients receiving an additional 6 months of postinduction MOPP (nitrogen mustard, vincristine, procarbazine, and prednisone). Patients receiving only 6 months of induction BVCPP (BCNU, vinblastine, cyclophosphamide, procarbazine, and prednisone) had a relative risk of 166.2 (P less than 0.05). These data results are consistent with previous reports that patients treated for Hodgkin's disease are at high risk for development of AML. However, to date, no patients in this series have developed second malignancies other than AML.