Malignancies after hematopoietic cell transplantation for primary immune deficiencies: a report from the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant 2011 Dec;17(12):1783-9
Date
06/11/2011Pubmed ID
21658461Pubmed Central ID
PMC3370408DOI
10.1016/j.bbmt.2011.05.008Scopus ID
2-s2.0-81255185230 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
We describe the incidence of malignancy in patients with primary immunodeficiency disorders (PIDD) following hematopoietic cell transplantation (HCT). From the Center for International Blood and Marrow Transplant Research, 2266 PIDD patients who had undergone allogeneic HCT between 1968 and 2003 were identified. Patient, disease, and transplant factors for development of malignancy were examined and pathology reports for reported malignancies reviewed independently by a pathologist for confirmation. The incidence of malignancy was highest for Wiskott-Aldrich syndrome (3.3%), with an overall incidence of 2.3% for PIDD. Post-HCT malignancy was confirmed for 52 of 63 reported cases. Forty-five of 52 patients developed posttransplant lymphoproliferative disorders (PTLD) at a median of 3 months post-HCT. Of these, 26 had received T cell-depleted (TCD) bone marrow. Three patients who developed myelodysplastic syndrome had received TCD marrow and total body irradiation. Three patients developed a solid tumor. Patients with PIDD are at a relatively low risk of developing malignancies post-HCT compared with their historic risk of cancer. The most frequent malignancy or lymphoproliferative disorder was early-onset PTLD. As in other HCT recipients, TCD appears to correlate with PTLD development. Our results lend support to the hypothesis that immune reconstitution in PIDD following HCT leads to a decrease in cancer risk.
Author List
Kamani NR, Kumar S, Hassebroek A, Eapen M, LeRademacher J, Casper J, Cowan M, Sánchez de Toledo J, Ferster A, Szabolcs P, Wingard JR, Horwitz E, Filipovich AHAuthor
Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Child
Child, Preschool
Cohort Studies
Female
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Immunologic Deficiency Syndromes
Infant
Male
Middle Aged
Risk Factors
Transplantation, Homologous
Young Adult