@article{Moser_Zimmermann_Meyer_Klapper_Oschlies_Schrappe_Attarbaschi_Mann_Niggli_Spix_Kontny_Klingebiel_Reiter_Burkhardt_Woessmann_2021, place={Pavia, Italy}, title={Second malignancies after treatment of childhood non-Hodgkin lymphoma: a report of the Berlin-Frankfurt-Muenster study group}, volume={106}, url={https://haematologica.org/article/view/9720}, DOI={10.3324/haematol.2019.244780}, abstractNote={Abstract Second malignant neoplasms pose a concern for survivors of childhood cancer. We evaluated incidence, type and risk factors for second malignant neoplasms in patients included in Berlin-Frankfurt-Muenster protocols for childhood non-Hodgkin lymphoma. 3590 patients <15 years of age at diagnosis registered between 01/1981 and 06/2010 were analyzed. Second malignant neoplasms were reported by the treating institutions and the German Childhood Cancer Registry. After median follow-up of 9.4 years (Quartile, Q1 6.7 and Q3 12.1) 95 second malignant neoplasms were registered (26 carcinomas including 9 basal cell carcinomas, 21 acute myeloid leukemias/myelodysplastic syndromes, 20 lymphoid malignancies, 12 CNS-tumors, and 16 other). Cumulative incidence at 20 years was 5.7±0.7%, standard incidence ratio excluding basal cell carcinomas was 19.8 (95% CI 14.5-26.5). Median time from initial diagnosis to second malignancy was 8.7 years (range: 0.2-30.3). Acute-lymphoblastic-leukemia-type therapy, cumulative anthracycline dose, and cranial radiotherapy for brain tumor-development were significant risk factors in univariate analysis only. In multivariate analysis including risk factors significant in univariate analysis, female sex (HR 1.87, 95% CI 1.23-2.86, p=0.004), CNS-involvement (HR 2.24, 95% CI 1.03-4.88, p=0.042), lymphoblastic lymphoma (HR 2.60, 95% CI 1.69-3.97, p<0.001), and cancer-predisposing condition (HR 11.2, 95% CI 5.52-22.75, p&lt;0.001) retained an independent risk. Carcinomas were the most frequent second malignant neoplasms after non-Hodgkin lymphoma in childhood followed by acute myeloid leukemia and lymphoid malignancies. Female sex, lymphoblastic lymphoma, CNS-involvement, or/and known cancer-predisposing condition were risk factors for second malignant neoplasm-development. Our findings set the basis for individualized long-term follow-up and risk assessment of new therapies.}, number={5}, journal={Haematologica}, author={Moser, Olga and Zimmermann, Martin and Meyer, Ulrike and Klapper, Wolfram and Oschlies, Ilske and Schrappe, Martin and Attarbaschi, Andishe and Mann, Georg and Niggli, Felix and Spix, Claudia and Kontny, Udo and Klingebiel, Thomas and Reiter, Alfred and Burkhardt, Birgit and Woessmann, Wilhelm}, year={2021}, month={Apr.}, pages={1390-1400} }