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. 2022 Jan;34(1):163-170.
doi: 10.1111/den.14004. Epub 2021 Jun 8.

Clinicopathological features and risk factors for developing colorectal neoplasia in Hodgkin's lymphoma survivors

Berbel L M Ykema  1 , Lisanne S Rigter  1 , Manon C W Spaander  2 , Leon M G Moons  3 , Tanya M Bisseling  4 , Berthe M P Aleman  5 , Evelien Dekker  6 , Wieke H M Verbeek  1 , Ernst J Kuipers  2 , Jan Paul de Boer  7 , Pieternella J Lugtenburg  8 , Cecile P M Janus  9 , Eefke J Petersen  10 , Judith M Roesink  11 , Richard W M van der Maazen  12 , Gerrit A Meijer  13 , Michael Schaapveld  14 , Flora E van Leeuwen  14 , Beatriz Carvalho  13 , Petur Snaebjornsson  13 , Monique E van Leerdam  1   15
Affiliations

Clinicopathological features and risk factors for developing colorectal neoplasia in Hodgkin's lymphoma survivors

Berbel L M Ykema et al. Dig Endosc. 2022 Jan.

Abstract

Background: Hodgkin's lymphoma (HL) survivors treated with abdominal radiotherapy and/or procarbazine have an increased risk of developing colorectal neoplasia.

Aims: We evaluated the clinicopathological characteristics and risk factors for developing (advanced) neoplasia (AN) in HL survivors.

Methods: In all, 101 HL survivors (median age 51 years, median age of HL diagnosis 25 years) underwent colonoscopy and 350 neoplasia and 44 AN (classified as advanced adenomas/serrated lesions or colorectal cancer), mostly right-sided, were detected, as published previously. An average-risk asymptomatic cohort who underwent screening colonoscopy were controls (median age 60 years). Clinicopathological characteristics of AN were evaluated in both groups. Mismatch repair (MMR) status was assessed using immunohistochemistry (MLH1/MSH2/MSH6/PMS2). Logistic regression analysis was performed to evaluate the risk factors for AN in HL survivors, including age at HL diagnosis and interval between HL and colonoscopy.

Results: In 101 colonoscopies in HL survivors, AN was primarily classified based on polyp size ≥10 mm, whereas (high-grade)dysplasia was more often seen in AN in controls. An interval between HL diagnosis and colonoscopy >26 years was associated with more AN compared with an interval of <26 years, with an odds ratio for AN of 3.8 (95% confidence interval 1.4-9.1) (p < 0.01). All 39 AN that were assessed were MMR proficient.

Conclusions: Colorectal neoplasia in HL survivors differ from average-risk controls; classification AN was primarily based on polyp size (≥10 mm) in HL survivors. Longer follow-up between HL diagnosis and colonoscopy was associated with a higher prevalence of AN in HL survivors.

Keywords: DNA mismatch repair; Hodgkin's lymphoma; cancer survivors; colonoscopy; colorectal neoplasms.

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Conflict of interest statement

Authors declare no conflict of interest for this article.

Figures

Figure 1
Figure 1
The location of each type of neoplasia – any type of colorectal neoplasia, nonadvanced adenoma, nonadvanced serrated lesion, and advanced neoplasia – in Hodgkin’s lymphoma survivors (n = 101) and controls (n = 1426). The location was classified as right (cecum to transverse colon) or left (splenic flexure to rectum) and calculated for every neoplasia detected in percent.
See this image and copyright information in PMC

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