Critical Care Medicine-Hematologic and Oncologic Disorders>>>>>White Blood Cell Disorders
Question 5#

All the following are possible long-term complications of treatment of non-Hodgkin lymphoma (NHL) EXCEPT:

A. Breast cancer
B. Stroke
C. Congestive heart failure
D. Adrenal insufficiency

Correct Answer is D


Correct Answer: D

Improvements in therapy for NHL have resulted in increasing numbers of long-term survivors of this disease. Because NHL is a heterogeneous group of diseases, there are multiple treatment options including radiation therapy, chemotherapy, immunotherapy, and any combination of these. The treatment a patient receives depends on the histologic subtype of NHL and disease stage. Complications resulting from treatment include second malignancies, cardiovascular disease, endocrine dysfunction, and neurologic complications. 

Second malignancies occurring after treatment of NHL include breast cancer, lung cancer, cancers of the gastrointestinal tract, as well as leukemia and skin cancers. Cardiovascular complications including cardiomyopathy, heart failure, valvular heart disease, and coronary artery disease may arise from either chemotherapy or radiation therapy or both. The risk of stroke is increased after neck irradiation. Pulmonary fibrosis may occur after lung irradiation or as a result of certain chemotherapeutic agents. Hypothyroidism and infertility due to gonadal dysfunction may also occur after treatment for NHL.

The adrenal gland involvement in disseminated lymphoma or as primary adrenal NHL may result in adrenal insufficiency. 


  1. Boyne DJ, Mickle AT, Brenner DR, et al. Long-term risk of cardiovascular mortality in lymphoma survivors: a systematic review and metaanalysis. Cancer Med. 2018;7:4801-4813.
  2. Ng AK, LaCasce A, Travis LB. Long-term complications of lymphoma and its treatment. J Clin Oncol. 2011;29:1885-1892.