Second Solid Cancers after Allogeneic Hematopoietic Cell Transplantation Using Reduced-Intensity Conditioning
| Autor: | Uday R. Popat, Muthalagu Ramanathan, Kimberly A. Kasow, Alison W. Loren, Jack W. Hsu, Yoshiko Atsuta, Rammurti T. Kamble, Harry C. Schouten, Amir Steinberg, Olle Ringdén, Gregory A. Hale, Bipin N. Savani, Joerg Halter, Robert J. Hayashi, Linda J. Burns, Naynesh Kamani, David A. Jacobsohn, Wael Saber, Christine Duncan, Zhiwei Wang, John R. Wingard, Nandita Khera, Navneet S. Majhail, Jonas Mattsson, Jean-Yves Cahn, Ruta Brazauskas, David I. Marks, David Buchbinder, Hillard M. Lazarus, Mohamed L. Sorror, Gérard Socié, Kasiani C. Myers, Ibrahim Ahmed |
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| Přispěvatelé: | RS: GROW - Oncology, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy |
| Rok vydání: | 2014 |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment Population Hematopoietic stem cell transplantation 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine Solid tumors medicine Cumulative incidence Nonmyeloablative conditioning education Transplantation education.field_of_study Hematopoietic cell transplantation business.industry Hazard ratio Cancer Hematology medicine.disease 3. Good health Surgery Reduced-intensity conditioning Leukemia Standardized mortality ratio Second cancers 030220 oncology & carcinogenesis business 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation, 20(11), 1777-1784. Elsevier Science |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2014.07.009 |
| Popis: | We examined risk of second solid cancers after allogeneic hematopoietic cell transplantation (AHCT) using reduced-intensity/nonmyeloablative conditioning (RIC/NMC). RIC/NMC recipients with leukemia/myelodysplastic syndrome (MDS) (n = 2833) and lymphoma (n = 1436) between 1995 and 2006 were included. In addition, RIC/NMC recipients 40 to 60 years of age (n = 2138) were compared with patients of the same age receiving myeloablative conditioning (MAC, n = 6428). The cumulative incidence of solid cancers was 3.35% at 10 years. There was no increase in overall cancer risk compared with the general population (leukemia/MDS: standardized incidence ratio [SIR] .99, P = 1.00; lymphoma: SIR .92, P = .75). However, risks were significantly increased in leukemia/MDS patients for cancers of lip (SIR 14.28), tonsil (SIR 8.66), oropharynx (SIR 46.70), bone (SIR 23.53), soft tissue (SIR 12.92), and vulva (SIR 18.55) and skin melanoma (SIR 3.04). Lymphoma patients had significantly higher risks of oropharyngeal cancer (SIR 67.35) and skin melanoma (SIR 3.52). Among RIC/NMC recipients, age >50 years was the only independent risk factor for solid cancers (hazard ratio [HR] 3.02, P < .001). Among patients ages 40 to 60 years, when adjusted for other factors, there was no difference in cancer risks between RIC/NMC and MAC in leukemia/MDS patients (HR .98, P = .905). In lymphoma patients, risks were lower after RIC/NMC (HR .51, P = .047). In conclusion, the overall risks of second solid cancers in RIC/NMC recipients are similar to the general population, although there is an increased risk of cancer at some sites. Studies with longer follow-up are needed to realize the complete risks of solid cancers after RIC/NMC AHCT. (C) 2014 American Society for Blood and Marrow Transplantation. |
| Databáze: | OpenAIRE |
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