Immune-related perturbation may contribute to development of melanoma in survivors of some forms of non-Hodgkin lymphoma (NHL), according to a recent study published online ahead of print in the Journal of Clinical Oncology.

Researchers led by Clara Lam, MD, of the National Cancer Institute in Maryland looked at risk of second melanoma in 44,870 1-year survivors of first primary NHL from 1992 to 2009 from the SEER-Medicare database, noting treatment information, autoimmune disease, and infections from Medicare claims.

“Previous studies have reported that survivors of NHL have an increased risk of developing cutaneous melanoma,” the authors noted. “However, risks associated with specific treatments and immune-related risk factors have not been quantified.”

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Among 202 second melanoma cases that occurred in survivors of NHL, 91 were after chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) while 111 were after other NHL subtypes.

Melanoma risk after CLL/SLL was significantly higher in patients who had received infused fludarabine-containing chemotherapy with or without rituximab. Higher melanoma risk was also associated T-cell activating autoimmune diseases that were diagnosed before CLL/SLL.

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However, among those patients with other NHL subtypes, melanoma risk was not associated with specific treatments or with T-cell/B-cell immune conditions.

“Increased vigilance is warranted among survivors of NHL to maximize opportunities for early detection of melanoma,” the authors concluded.


  1. Lam CJK, Curtis RE, Dores GM, et al. Risk Factors for Melanoma Among Survivors of Non-Hodgkin Lymphoma. Journal of Clinical Oncology. 2015. [epub ahead of print]. doi:10.1200/JCO.2014.60.2094.