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. 2021 Sep 2;138(9):785-789.
doi: 10.1182/blood.2020010497.

The bidirectional increased risk of B-cell lymphoma and T-cell lymphoma

Dai Chihara  1 , Graça M Dores  2   3 , Christopher R Flowers  1 , Lindsay M Morton  3
Affiliations

The bidirectional increased risk of B-cell lymphoma and T-cell lymphoma

Dai Chihara et al. Blood. .

Abstract

Lymphoma survivors have a significantly higher risk of developing second primary lymphoma than the general population; however, bidirectional risks of developing B- and T-cell lymphomas (BCLs and TCLs) specifically are less well understood. We used population-based cancer registry data to estimate the subtype-specific risks of second primary lymphoma among patients with first BCL (n = 288 478) or TCL (n = 23 747). We observed nearly fivefold increased bidirectional risk between BCL and TCL overall (TCL following BCL: standardized incidence ratio [SIR] = 4.7, 95% confidence interval [CI] = 4.2-5.2; BCL following TCL: SIR = 4.7, 95% CI = 4.1-5.2), but the risk varied substantially by lymphoma subtype. The highest SIRs were observed between Hodgkin lymphoma (HL) and peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) (PTCL-NOS following HL: SIR = 27.5; HL following PTCL-NOS: SIR = 31.6). Strikingly elevated risks also were notable for angioimmunoblastic T-cell lymphoma (AITL) and diffuse large B-cell lymphoma (DLBCL) (AITL following DLBCL: SIR = 9.7; DLBCL following AITL: SIR = 15.3). These increased risks were strongest within the first year following diagnosis but remained persistently elevated even at ≥5 years. In contrast, SIRs were <5 for all associations of TCL with chronic lymphocytic leukemia/small lymphocytic lymphoma and follicular lymphoma. These patterns support etiologic heterogeneity among lymphoma subtypes and provide further insights into lymphomagenesis.

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Figures

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Graphical abstract
Figure 1.
Figure 1.
SIRs with 95% CIs for the reciprocal associations between BCL and TCL. (A) HL. (B) DLBCL. (C) FL. (D) CLL/SLL. (E) MZL. Numbers shown represent the observed cases of second primary lymphoma. Red diamonds correspond to TCL following BCL, and white diamonds correspond to BCL following TCL. leuk/lymph, leukemia/lymphoma.
See this image and copyright information in PMC

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