Faculty Collaboration Database

Risk factors for the development of cutaneous melanoma after allogeneic hematopoietic cell transplantation. J Am Acad Dermatol 2020 Sep;83(3):762-772

Date

10/28/2019

Pubmed ID

31654664

Pubmed Central ID

PMC7206613

DOI

10.1016/j.jaad.2019.10.034

Scopus ID

2-s2.0-85081343594 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: Melanoma risk is increased after allogeneic hematopoietic cell transplantation (HCT), but specific risk factors are unknown.

OBJECTIVE: Investigate risk factors for melanoma after allogeneic hematopoietic cell transplantation.

METHODS: We conducted a nested case-control study of 140 melanoma cases and 557 controls (matched by age at HCT, sex, primary disease, survival time) through the Center for International Blood and Marrow Transplant Research.

RESULTS: Melanoma risk was significantly increased among HCT survivors who received total body irradiation-based myeloablative conditioning (multivariable adjusted odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.00-3.15) or reduced-intensity conditioning containing melphalan (OR = 2.60; 95% CI = 1.13-6.02) or fludarabine (OR = 2.72; 95% CI = 1.02-7.30) versus busulfan-based myeloablative regimens; were diagnosed with acute graft-versus-host disease (GVHD) with stage 2+ skin involvement (OR = 1.92; 95% CI = 1.19-3.10), chronic GvHD without skin involvement (OR = 1.91; 95% CI = 1.03-3.57), or keratinocytic carcinoma (OR = 2.37; 95% CI = 1.16-4.83); and resided in areas with higher ambient ultraviolet radiation (ORtertile3 = 1.64; 95% CI = 1.01-2.67).

LIMITATIONS: Data on individual-level ultraviolet radiation exposure and clinical data on melanoma characteristics were lacking. Additionally, misclassification of melanoma is possible as not all pathology reports were available for review.

CONCLUSION: These results emphasize the importance of adherence to current surveillance guidelines (routine skin examination, photoprotection recommendations), particularly for HCT survivors at highest risk.

Author List

Herr MM, Curtis RE, Tucker MA, Tecca HR, Engels EA, Cahoon EK, Battiwalla M, Buchbinder D, Flowers ME, Brazauskas R, Shaw BE, Morton LM

Authors

Ruta Brazauskas PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin

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

Adolescent
Adult
Age Factors
Aged
Busulfan
Case-Control Studies
Child
Child, Preschool
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Infant
Karnofsky Performance Status
Male
Melanoma
Melphalan
Middle Aged
Neoplasm Staging
Risk Factors
Skin
Skin Neoplasms
Tissue Donors
Transplantation Conditioning
Ultraviolet Rays
Vidarabine
Whole-Body Irradiation
Young Adult