Introduction:
Haematooncological diseases and their therapy can trigger permanent immunosuppression
and thus encourage the development of further neoplasia. The weakened immune system
can also influence the prognosis of secondary neoplasia in the head and neck area.
Methods:
Retrospective case series on patients with head and neck cancer following the onset
of haematooncological disease (n = 15). Investigation of tumor stage, previous therapy
and course of disease.
Results:
The mean age at time of initial diagnosis was 51 years for the haematooncological
disease and 62 years for the head and neck cancer. The mean duration between initial
diagnosis of the haematooncological disease and the head and neck cancer was 137 +/-
111 months. All patients received immunosuppressive radio-, chemo- and/or immunotherapy
for the haematooncological disease. Secondary malignancies in the head and neck area
showed a recurrence or progression under therapy in 67% despite standard therapy,
in 53% within the first year. In three cases, a third carcinoma occurred in the head
and neck area. In four cases, patients developed another malignant tumor outside the
head and neck area. In two patients, an additional risk factor was immunosuppressive
therapy due to a preexisting autoimmune disease.
Conclusion:
Patients with head and neck cancer after haematooncological diseases show markedly
unfavorable courses of disease with tumor progression under therapy, increased risk
of recurrence and secondary malignancies. Therefore, a close tumor follow-up is of
major importance. Adjuvant immune-enhancing measures may have a positive impact on
the course of disease.
