Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2014
Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Ringdén Olle, Brazauskas Ruta, Wang Zhiwei, Ahmed Ibrahim, Atsuta Yoshiko, Buchbinder David, Burns Linda J, Cahn Jean-Yves, Duncan Christine, Hale Gregory A, Halter Joerg, Hayashi Robert J, Hsu Jack W, Jacobsohn David A, Kamble Rammurti T, Kamani Naynesh R, Kasow Kimberly A, Khera Nandita, Lazarus Hillard M, Loren Alison W, Marks David I, Myers Kasiani C, Ramanathan Muthalagu, Saber Wael, Savani Bipin N, Schouten Harry C, Socie Gérard, Sorror Mohamed L, Steinberg Amir, Popat Uday, Wingard John R, Mattsson Jonas, Majhail Navneet S
Аннотация
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.