LYMPHATIC AND HEMATOPOIETIC TISSUES

In Denmark, 6.6% of all malignant neoplasms among men and 5.5% among w omen occur in the lymphatic and haematopoietic tissues. Most are gener alized when diagnosed, although lymphomas are sometimes confined to on e region. Treatment has been predominantly by chemotherapy since the 1 960s, and is often combined with radiation for lymphomas and myeloma. The five-year survival rates for non-Hodgkin's lymphoma improved by 20 % between 1970 and 1987. An improvement in survival from Hodgkin's dis ease began earlier, with a relative five-year survival rate of about 3 0% in 1960 and of 72% in 1983-87. Survival was better for younger pati ents (< 50 years) with stage I-II disease, the relative five-year surv ival rates being 83-93% in 1983-87. For cases of leukaemia much of the improvement in survival rates was founded in 1960s on success in the treatment of childhood leukaemia (acute lymphatic leukaemia): the rela tive five-year survival rates for children under 10 years of age incre ased from 12% to 75-80%. Smaller improvements were seen in survival fr om other types of leukaemia, including the chronic forms. Thus, even f or chronic lymphocytic leukaemia, which has a favourable prognosis but is regarded as incurable, improvements in survival rates were seen, w hich may be attributed to chemotherapeutic treatment or earlier diagno sis. It was not surprising that the dramatic improvement in survival r ates coincided with the introduction of chemotherapeutic treatment reg imes, as reported perviously in clinical series. Acute and chronic cyt otoxic side-effects are of concern, and, since both cytotoxic drugs an d radiation are potent carcinogens, second primary cancers have been r eported to be induced by treatment of cancers (Storm & Prener, 1985). The improvements in the survival rates for the haematopoietic malignan cies, however, outweigh the de novo cancer risk related to therapy.