Is there an increased rate of additional malignancies in patients with mantle cell lymphoma?

Purpose: To examine the frequency of additional neoplasms preceding and following the diagnosis of mantle cell lymphoma (MCL). Patients and methods: A total of 156 patients with MCL treated on the hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternated with methotrexate and cytosine arabinoside (Hyper-CVAD/M-A) program with or without rituximab from 1994 to 2000 were the subjects of this report. Results: These patients were followed for a median time of 26 months, and a total of 32 (21 %) additional neoplasms were diagnosed, 21 preceding the diagnosis of MCL and 1 I following MCL. After excluding certain types of non-invasive neoplasms, including basal cell carcinoma, meningioma and cervical intraepithelial neoplasia, we observed seven second malignancies after the diagnosis of MCL, and the 5-year cumulative incidence rate of second malignancy was 11%. The observed-to-expected (O/E) ratio was 7/0.07 = 100 [95% confidence interval (CI) 49.3 to 186.6; P