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Improvements in the treatment of both Hodgkin’s and non  Hodgkin’s Lymphomas (HL and NHL) have resulted in an increasing number of long term survivors.  But  this patient’s  population is at high risk of developing serious late therapy related complications that can negatively affect their lives or lead them to an early death. The most common secondary diseases in the people cured from lymphomas  are cardiovascular diseases, second malignancies (mainly solid tumours) and endocrinopathies that in the majority of the cases are thyroid dysfunctions.

In our institution the HL and aggressive NHL long term survivors are followed up in a dedicated clinic since September 2014. Here we report preliminary data on second malignancies and thyroid dysfunctions.

We have analyzed data regarding 216 patients coming in our clinic from 15 September 2014 to 16 February 2015, 119  were affected by HL and 97 by NHL.  One hundred fifteen are females, 101 males; median age at observation is 53 (range 22-89). All of them are in complete response for lymphoma for at least 5 years from the completions of curative therapy.

Thirty patients (28 females and 2 males) had thyropathies (13.8%),namely hypothyroidism interesting 25 of them and multinodular goiter in 5 cases. Twenty six had a previous HL but only 4 developed endocrinopaties after a NHL. According to lymphoma therapies, 26 (24 HL and 2 NHL) of them had neck and/or mediastinal radiotherapy. They are the 26.5% of all receiving  irradiation in the chest and neck; the other 4 did not had radiotherapy.

Twenty four patients (11%) experienced a second cancer, 3 of them had 2 neoplasms, so we documented 27 second tumours. They were: 8 breast,  7 skin basocellular, 3 colon and sigma, 3 thyroid, 2 prostatic, 1 lung, 1 bladder carcinoma, 1 testis and 1 cutaneous appendages cancer. Regarding  the previous therapies all but 2 the females with breast cancer had undergone to mediastinal radiotherapy ; 5 out of 7 with cutaneous cancer developed the lesion in the sites of previous irradiation; 1 out of 3 with thyroid cancer had mantel radiotherapy, the one with lung cancer had MOPP chemotherapy and mantle radiotherapy; no one of the intestinal cancers had abdominal radiotherapy, the one with urinary cancer had abdominal radiotherapy and MOPP/ABVD regimen.

Median age of breast cancer in our setting is 50.5 (range 38-70). The median time between diagnosis of lymphoma and diagnosis of second malignancy was 21 years (range 5-41).

Our data confirm the incidence of thyroid diseases in lymphoma survivors particularly in people with prior HL. In our Department we described also numerous cases of second neoplasms in the lymphoma survivors population. That outline the importance of a plan for early diagnosis of cancers in this setting of patients.