Hodgkin's lymphoma--cancer of the lymph nodes--arises in more than 150 children and adolescents in Germany each year. Nine out of ten patients survive the disease, thanks to the highly effective treatments that are now available. Depending on the type of treatment given, however, there may be late sequelae, as discussed by Wolfgang Dörffel and colleagues in an original article in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2015; 112: 320-7). These authors studied the question of which types of treatment were more likely to be followed by the development of secondary malignant neoplasia, and they quantified the risk of such an event as a function of the treatment received.
Hodgkin's lymphoma is usually treated with both chemotherapy and radiotherapy. Depending on the particular combination of agents used, and on the intensity of treatment, some patients develop other types of cancer years afterward; for example, some patients treated with radiotherapy later develop malignant neoplasms as a consequence of their treatment. Overall, one in every four or five patients treated for Hodgkin's lymphoma in childhood or adolescence developed a second type of cancer within 30 years of treatment. The authors recommend that patients be informed about the possible late sequelae of treatment and undergo regular follow-up. Moreover, radiotherapy in children and adolescents should be given at reduced doses or avoided entirely.