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Non-Hodgkin's Lymphoma After Treatment of Hodgkin's Disease-Reply

James O. Armitage, MD; Fred R. Dick, MD; James A. Goeken, MD; Kathy Foucar, MD; Roger D. Gingrich, MD
Arch Intern Med. 1983;143(12):2339. doi:10.1001/archinte.1983.00350120137038.
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In Reply.  —The classification of second lymphoid neoplasms occurring in patients treated for HD is often difficult. It is for this reason that we referred to these tumors as "second lymphoid malignant neoplasms" rather than "non-Hodgkin's lymphomas." This difficulty in classification can also occur in patients seen with de novo non-Hodgkin's lymphoid neoplasms. For example, the difference between T-cell acute lymphoblastic leukemia and lymphoblastic lymphoma is often an arbitrary distinction. Two of the patients in our series and some other previously described patients had peripheral blood involvement at the time of the diagnosis of a second lymphoid malignant neoplasm and might have been classified as having leukemia. It is likely that patients with peripheral blood involvement are more likely to be recognized than patients with only recurrent lymphadenopathy, because peripheral blood involvement would be a particularly unusual manifestation of Hodgkin's disease.Although acute lymphoblastic leukemia has been recognized in patients


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