Razi Journal of Medical Sciences

  Hodgkin’s disease is one of the most common childhood malignancies that with correct diagnosis and effective treatment is curable and without treatment is leading to death.

  The survival of patients with Hodgkin’s disease has dramatically improved over the past 30 years because of advances in treatment.

  However, concern for the risk of long tern complications has resulted in a number of trials to evaluate reduction of therapy. Causes of second malignancy are related to therapies (radiotherapy-chemotherapy-radiotherapy with chemotherapy), age of patients in the first treatment, sex and immunological deficits associated with Hodgkin’s disease. Two third of second malignancies are solid tumors and 1/3 are hematologic and lymphatic system cancer.

  In patients that treated first with radiotherapy, solid tumors appears higher and in patients treated first with chemotherapy leukemia appears higher. With this reuslts in childhood malignancies radiotherapy sholud be reduced and when patients treated with chemotherapy the cycles of treatment should be reduced too, and all patients should have follow up for second malignancy for several years. In 228 patients with Hodgkin’s disease in ten years in Hazrat Ali-Asghar Hospital, 4 second malignancies were occurred.

  Three cases presented with solid tumor and one case with leukemia (AML). Three cases that first treated with radiotherapy after 8, 18 and 19 years later (respectively) presented with solid tumor, one case died from brain tumor and two cases presented with thyroid cancer, had thyroidectomy and are alive. One case after 6 years of repeated chemotherapy for recurrent disease developed leukemia and finally died. Because in this center, radiotherapy is restricted, the incidence of second malignancy is less than other centers.