Solid cancers after allogeneic hematopoietic cell transplantation Journal Article
| Authors: | Rizzo, J. D.; Curtis, R. E.; Socié, G.; Sobocinski, K. A.; Gilbert, E.; Landgren, O.; Travis, L. B.; Travis, W. D.; Flowers, M. E. D.; Friedman, D. L.; Horowitz, M. M.; Wingard, J. R.; Deeg, H. J. |
| Article Title: | Solid cancers after allogeneic hematopoietic cell transplantation |
| Abstract: | Transplant recipients have been reported to have an increased risk of solid cancers but most studies are small and have limited ability to evaluate the interaction of host, disease, and treatment-related factors. In the largest study to date to evaluate risk factors for solid cancers, we studied a multi-institutional cohort of 28 874 allogeneic transplant recipients with 189 solid malignancies. Overall, patients developed new solid cancers at twice the rate expected based on general population rates (observed-to-expected ratio 2.1; 95% confidence interval 1.8-2.5), with the risk increasing over time (P trend < .001); the risk reached 3-fold among patients followed for 15 years or more after transplantation. New findings showed that the risk of developing a non-squamous cell carcinoma (non-SCC) following conditioning radiation was highly dependent on age at exposure. Among patients irradiated at ages under 30 years, the relative risk of non-SCC was 9 times that of nonirradiated patients, while the comparable risk for older patients was 1.1 (P interaction < .01). Chronic graft-versus-host disease and male sex were the main determinants for risk of SCC. These data indicate that allogeneic transplant survivors, particularly those irradiated at young ages, face increased risks of solid cancers, supporting strategies to promote lifelong surveillance among these patients. © 2009 by The American Society of Hematology. |
| Keywords: | adolescent; adult; child; controlled study; preschool child; school child; retrospective studies; transplantation, homologous; major clinical study; busulfan; clinical trial; mortality; squamous cell carcinoma; cancer risk; solid tumor; comparative study; methotrexate; follow up; melanoma; breast cancer; risk factors; cyclophosphamide; hematopoietic stem cell transplantation; age factors; retrospective study; risk factor; skin carcinoma; time; time factors; age; risk assessment; confidence interval; chronic disease; acute graft versus host disease; chronic graft versus host disease; whole body radiation; infant; multicenter study; irradiation; carcinoma; graft versus host reaction; transplantation conditioning; allogeneic hematopoietic stem cell transplantation; brain cancer; sex difference; thyroid cancer; neoplasms, second primary; second cancer; sex factors; t cell depletion; gender; immunosuppressive treatment; cyclosporin a; graft vs host disease; mouth carcinoma; allotransplantation; thymocyte antibody; whole-body irradiation; bone cancer; lymphocyte antibody; blood group incompatibility; hla system |
| Journal Title: | Blood |
| Volume: | 113 |
| Issue: | 5 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2009-01-29 |
| Start Page: | 1175 |
| End Page: | 1183 |
| Language: | English |
| DOI: | 10.1182/blood-2008-05-158782 |
| PUBMED: | 18971419 |
| PROVIDER: | scopus |
| PMCID: | PMC2635083 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 17" - "Export Date: 30 November 2010" - "CODEN: BLOOA" - "Source: Scopus" |
