Evaluating the risk of secondary cancers from infections in patients with non-Hodgkin’s lymphoma

This study examined whether there is a link between the type of non-Hodgkin’s lymphoma (NHL) and the development of secondary cancer due to certain infections.  The authors concluded that patients with diffuse large B-cell lymphoma (DLBCL) or marginal zone lymphoma (MZL) may be at risk for developing a second type of cancer.

There are several different types of NHL. Previous studies have shown that infections may contribute to certain types of NHL. These include DLBCL and MZL, which have been associated with hepatitis C and HIV, respectively. However, these infections have not been associated with other common types of NHL, such as chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL). 

After initial treatment, some patients with NHL may develop another type of cancer. Some types of infections have been associated with different types of cancer. For example, human papillomavirus (HPV) has been linked to the development of cancers affecting the stomach, liver, and lungs. Whether patients with NHL are at risk of developing secondary cancer related to infection remains unclear.

This study included medical records from 127,044 patients with NHL. These records were analyzed to see if these patients developed secondary cancer due to certain types of infections.  This risk of developing secondary cancers was compared to that of the general population. Patients were followed-up for an average of 4.5 to 5.2 years.

One year after NHL diagnosis, the rates of secondary cancers were found to be higher with some types of NHL. Stomach cancer, frequently caused by Helicobacter pylori, was much higher for patients with MZL than patients with DLBCL (1.5 times higher vs. 2.78 times higher).  Liver cancer, sometimes caused by hepatitis C, was slightly higher for patients with MZL compared to patients with DLBCL (1.98 times higher vs. 1.85 times higher). 

The risk of developing anal cancer, commonly caused by HIV, was much higher for patients with DLBCL compared to patients with MZL (2.36 times higher vs. 3.71 times higher). In patients with DLBCL, this risk was higher for patients with HIV compared to those without (68.34 times higher vs. 2.09 times higher).

Patients with CLL or FL did not have increased risk of stomach, liver and anal cancer.  Throat and cervical cancer were not higher in any of the NHL types. 

This study concluded that patients with DLBCL and MZL have a higher chance of developing stomach, liver and anal cancer.  This may be caused by certain infections such as Helicobacter pylori, hepatitis C and HIV. 

This study was carried out using retrospectively using cancer registry records. Some data was not available, such as infection status. The follow-up of patients also varied between NHL subtypes. More studies are needed to confirm these results.

Talk to your physician if you have concerns about secondary cancers.