© The Author 2006. Published by Oxford University Press.
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Acute Myeloid Leukemia Following Hodgkin Lymphoma: A Population-Based Study of 35 511 Patients
Affiliations of authors: Division of Cancer Epidemiology and Genetics (SJS, ESG, LBT), Division of Cancer Prevention (GMD), National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; The University of Iowa, Iowa City (CFL); Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, Toronto, Ontario, Canada (DCH); Karolinska Institutet, Stockholm, Sweden (PH, MK); Danish Cancer Society, Copenhagen, Denmark (HS, MA); Cancer Registry of Norway, Oslo (AA); Finnish Cancer Registry, Helsinki, Finland (EP); Cancer Care Ontario, Toronto, Ontario, Canada (EH); Helsinki University Central Hospital, Helsinki, Finland (HJ); Radiumhospitalet Trust, Oslo, Norway (SDF); The University of York, United Kingdom (JMA)
Correspondence to: Lois B. Travis, MD, ScD, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 6120 Executive Blvd., EPS # 7086, MSC 7238, Bethesda, MD 20892-7238 (e-mail: travisl{at}mail.nih.gov).
Treatments for Hodgkin lymphoma are associated with large relative risks of acute myeloid leukemia (AML), but there are few estimates of the excess absolute risk (EAR), a useful measure of disease burden. One-year Hodgkin lymphoma survivors (N = 35 511) were identified within 14 population-based cancer registries in Nordic countries and North America from January 1, 1970, through December 31, 2001. We used Poisson regression analysis to model the EAR of AML, per 10 000 person-years. A total of 217 Hodgkin lymphoma survivors were diagnosed with AML (10.8 expected; unadjusted EAR = 6.2; 95% confidence interval = 5.4 to 7.1). Excess absolute risk for AML was highest during the first 10 years after Hodgkin lymphoma diagnosis but remained elevated thereafter. In subsequent analyses, adjusted for time since Hodgkin lymphoma diagnosis and presented for the 5–9 year interval, the EAR was statistically significantly (P<.001) larger in patients diagnosed with Hodgkin lymphoma at age 35 years and older than in those diagnosed before 35 years of age. The EAR of AML declined statistically significantly after 1984 (7.0 to 4.2 and 16.4 to 9.9 in the <35 and 
35 age groups, respectively), which may be associated with modifications in chemotherapy.
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