Synchronous high-risk melanoma and lymphoid neoplasia

Large population-based studies have shown a significant association between melanoma and lymphoid neoplasia, particularly non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukaemia (CLL), that is independent of any treatm ent received for the Initial tumour. This study examines the presentation, diagnosis, treatment and progress of three patients who developed advanced melanoma concurrently with a lymphoid neoplasm (one NHL, two CLLs), in orde r to illustrate their association, discuss common aetiological factors and examine possible therapeutic options. As it is the melanoma rather than the lymphoid neoplasm that represents the bigger threat to overall survival, I nitial treatment should be targeted towards this cancer, However, because o f the interplay between the diseases and the possible side-effects of the v arious treatments, the choice of adjuvant therapy requires careful consider ation. Immunosuppression associated with chemotherapy may permit a more agg ressive course for the melanoma, while locoregional radiotherapy is contrai ndicated following lymph node dissections. As immunotherapy is of benefit i n the treatment of melanoma and has also been recently shown to be effectiv e in the management of lymphoid neoplasia, we instituted interferon-a as ad juvant therapy for these patients, thereby utilizing a single agent to trea t the dual pathologies. The three patients have now been followed-up for 6 months without evidence of disease recurrence or progression. (C) 2001 Lipp incott Williams & Wilkins.