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Solid cancers after allogeneic hematopoietic cell transplantation. Blood 2009 Jan 29;113(5):1175-83 PMID: 18971419 PMCID: PMC2635083

Pubmed ID

18971419

DOI

10.1182/blood-2008-05-158782

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.

Author List

Rizzo JD, Curtis RE, SociƩ G, Sobocinski KA, Gilbert E, Landgren O, Travis LB, Travis WD, Flowers ME, Friedman DL, Horowitz MM, Wingard JR, Deeg HJ

Authors

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Ctr Associate Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-60849115555   256 Citations

MESH terms used to index this publication - Major topics in bold

Age Factors
Chronic Disease
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Male
Neoplasms, Second Primary
Retrospective Studies
Risk Factors
Sex Factors
Time Factors
Transplantation Conditioning
Transplantation, Homologous
Whole-Body Irradiation
jenkins-FCD Prod-331 a335b1a6d1e9c32173c9534e6f6ff51494143916