Risk of hematological malignancies in the families of patients treated for nodular lymphocyte-predominant Hodgkin lymphoma

Saad Akhtar; M Shahzad Rauf; Amani Al-Kofide; Mahmoud A Elshenawy; Ali Hassan Mushtaq; Irfan Maghfoor

doi:10.1186/s13053-021-00175-0

Risk of hematological malignancies in the families of patients treated for nodular lymphocyte-predominant Hodgkin lymphoma

Hered Cancer Clin Pract. 2021 Feb 9;19(1):17. doi: 10.1186/s13053-021-00175-0.

Authors

Saad Akhtar¹, M Shahzad Rauf², Amani Al-Kofide³, Mahmoud A Elshenawy², Ali Hassan Mushtaq⁴, Irfan Maghfoor²

Affiliations

¹ King Faisal Specialist Hospital and Research Center, Oncology Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia. sakhtar@kfshrc.edu.sa.
² King Faisal Specialist Hospital and Research Center, Oncology Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia.
³ Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Kingdom of Saudi Arabia.
⁴ College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia.

Abstract

Background: Familial clustering of lymphoid and/or hematological malignancies (FHM) provides an opportunity to study the responsible genes. The data is limited in patients with lymphoid and hematological malignancies.

Methods: The lymphoma database was used to identify patients seen in our institution from 1998 to 2019 with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). We studied FHM by collecting detailed history of any malignancy in the family (FM).

Results: Two hundred NLPHL patients were identified. Contacting was not possible in 30 patients due to no response to the phone calls (22) and death [1]. 170/200 patients were interviewed; represented 167 families (3 patients with a family member with NLPHL). These 170 patients provided information about 8225 family members. These 167 families had a total of 329 family members with 334 malignancies (including 167 NLPHL patients and 5 members with 2 malignancies each). Of these 167 patients, 77 (46.1%) had no FM while 90 (53.9%) patients had a positive FM; 162 family members with 167 malignancies. Among these 167 families, 31 families (18.6%) had members with FHM +/- solid cancers. These 31 families had 35 family members (25 males:10 females) with 16 lymphomas: diffuse large B cell lymphoma [2], follicular center cell lymphoma [3], chronic lymphocytic leukemia/small lymphocytic lymphoma [3], non-Hodgkin lymphoma [2], classical HL [2], and NLPHL [4]. Total of 8 leukemia: acute lymphoblastic leukemia [4], acute myeloid leukemia [3], and leukemia - no subtyping [5]. These 35 FHM members are 1st [6], 2nd (16), and 3rd [7] degree relatives of 31 NLPHL patients. There are 4 families with NLPHL in family members; all these 8 NLPHL patients are male and are alive. The median total number of 1st + 2nd +3rd degree members are 81. The decrease in the age of diagnosis from 1st generation to the 2nd generation (anticipation) was noted in 13/17 patients; 2nd generation median age at diagnosis was 29.7 years vs 1st generation age 53 years (developed malignancy 23.3 years earlier).

Conclusion: FHM is frequent in NLPHL. This study provided us many important insights for planning future studies in terms of interviewing technique, time, and resource allocation and genetic testing.

Keywords: Familial hematological malignancy; Familial lymphoma; Familial malignancy; Hereditary malignancy; Hodgkin lymphoma; Nodular lymphocyte-predominant Hodgkin lymphoma.