Solid cancers after allogeneic hematopoietic cell transplantation
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 m...
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| Veröffentlicht in: | BLOOD 2009-01, Vol.113 (5), p.1175-1183 |
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| creator | Rizzo, J. Douglas Curtis, Rochelle E. Socié, Gérard Sobocinski, Kathleen A. Gilbert, Ethel Landgren, Ola Travis, Lois B. Travis, William D. Flowers, Mary E.D. Friedman, Debra L. Horowitz, Mary M. Wingard, John R. Deeg, H. Joachim |
| description | 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. |
| doi_str_mv | 10.1182/blood-2008-05-158782 |
| format | Article |
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Douglas ; Curtis, Rochelle E. ; Socié, Gérard ; Sobocinski, Kathleen A. ; Gilbert, Ethel ; Landgren, Ola ; Travis, Lois B. ; Travis, William D. ; Flowers, Mary E.D. ; Friedman, Debra L. ; Horowitz, Mary M. ; Wingard, John R. ; Deeg, H. Joachim</creator><creatorcontrib>Rizzo, J. Douglas ; Curtis, Rochelle E. ; Socié, Gérard ; Sobocinski, Kathleen A. ; Gilbert, Ethel ; Landgren, Ola ; Travis, Lois B. ; Travis, William D. ; Flowers, Mary E.D. ; Friedman, Debra L. ; Horowitz, Mary M. ; Wingard, John R. ; Deeg, H. Joachim</creatorcontrib><description>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.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2008-05-158782</identifier><identifier>PMID: 18971419</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Age Factors ; Biological and medical sciences ; Chronic Disease ; Female ; Graft vs Host Disease - mortality ; Hematologic and hematopoietic diseases ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Medical sciences ; Neoplasms, Second Primary - etiology ; Neoplasms, Second Primary - mortality ; Retrospective Studies ; Risk Factors ; Sex Factors ; Time Factors ; Transplantation ; Transplantation Conditioning ; Transplantation, Homologous ; Whole-Body Irradiation</subject><ispartof>BLOOD, 2009-01, Vol.113 (5), p.1175-1183</ispartof><rights>2009 © 2009 by The American Society of Hematology</rights><rights>2009 INIST-CNRS</rights><rights>2009 by The American Society of Hematology 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-80eb64d6c0cdca235b6440e5eaec1af5b2bec591be10a7c6cfdb6562258e63b13</citedby><cites>FETCH-LOGICAL-c595t-80eb64d6c0cdca235b6440e5eaec1af5b2bec591be10a7c6cfdb6562258e63b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,550,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21100752$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18971419$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:118209117$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Rizzo, J. Douglas</creatorcontrib><creatorcontrib>Curtis, Rochelle E.</creatorcontrib><creatorcontrib>Socié, Gérard</creatorcontrib><creatorcontrib>Sobocinski, Kathleen A.</creatorcontrib><creatorcontrib>Gilbert, Ethel</creatorcontrib><creatorcontrib>Landgren, Ola</creatorcontrib><creatorcontrib>Travis, Lois B.</creatorcontrib><creatorcontrib>Travis, William D.</creatorcontrib><creatorcontrib>Flowers, Mary E.D.</creatorcontrib><creatorcontrib>Friedman, Debra L.</creatorcontrib><creatorcontrib>Horowitz, Mary M.</creatorcontrib><creatorcontrib>Wingard, John R.</creatorcontrib><creatorcontrib>Deeg, H. Joachim</creatorcontrib><title>Solid cancers after allogeneic hematopoietic cell transplantation</title><title>BLOOD</title><addtitle>Blood</addtitle><description>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.</description><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>Graft vs Host Disease - mortality</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neoplasms, Second Primary - etiology</subject><subject>Neoplasms, Second Primary - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Time Factors</subject><subject>Transplantation</subject><subject>Transplantation Conditioning</subject><subject>Transplantation, Homologous</subject><subject>Whole-Body Irradiation</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9kcFuFDEMhiMEotvCGyA0F7gNOJlJNntBqiooSJU4AOfI4_G0gexkSbJFvD1ZdtTSC6fE9uc_jn8hXkh4I6VVb4cQ49gqANuCbqW2a6seiZXUqiZAwWOxAgDT9pu1PBGnOX8HkH2n9FNxIm1N9nKzEudfYvBjQzgTp9zgVDg1GEK85pk9NTe8xRJ30XOpEXEITUk4513AuWDxcX4mnkwYMj9fzjPx7cP7rxcf26vPl58uzq9a0htdWgs8mH40BDQSqk7XqAfWjEwSJz2ogSspB5aAazI0jYPRRilt2XSD7M5Ee9TNv3i3H9wu-S2m3y6id0vqR72x00bq3lb-3ZGvlS2PxHMdPDxoe1iZ_Y27jrdOmU6D7arA60UgxZ97zsVtfT5sAGeO--yMsZVUUMH-CFKKOSee7h6R4A5eub9euYNXDrQ7elXbXv474H3TYk4FXi0AZsIw1b2Tz3eckhJgrdX9T7mu_9Zzcpk8V0NHn5iKG6P__yR_AAgqtgE</recordid><startdate>20090129</startdate><enddate>20090129</enddate><creator>Rizzo, J. Douglas</creator><creator>Curtis, Rochelle E.</creator><creator>Socié, Gérard</creator><creator>Sobocinski, Kathleen A.</creator><creator>Gilbert, Ethel</creator><creator>Landgren, Ola</creator><creator>Travis, Lois B.</creator><creator>Travis, William D.</creator><creator>Flowers, Mary E.D.</creator><creator>Friedman, Debra L.</creator><creator>Horowitz, Mary M.</creator><creator>Wingard, John R.</creator><creator>Deeg, H. Joachim</creator><general>Elsevier Inc</general><general>Americain Society of Hematology</general><general>American Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20090129</creationdate><title>Solid cancers after allogeneic hematopoietic cell transplantation</title><author>Rizzo, J. Douglas ; Curtis, Rochelle E. ; Socié, Gérard ; Sobocinski, Kathleen A. ; Gilbert, Ethel ; Landgren, Ola ; Travis, Lois B. ; Travis, William D. ; Flowers, Mary E.D. ; Friedman, Debra L. ; Horowitz, Mary M. ; Wingard, John R. ; Deeg, H. 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Douglas</au><au>Curtis, Rochelle E.</au><au>Socié, Gérard</au><au>Sobocinski, Kathleen A.</au><au>Gilbert, Ethel</au><au>Landgren, Ola</au><au>Travis, Lois B.</au><au>Travis, William D.</au><au>Flowers, Mary E.D.</au><au>Friedman, Debra L.</au><au>Horowitz, Mary M.</au><au>Wingard, John R.</au><au>Deeg, H. Joachim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Solid cancers after allogeneic hematopoietic cell transplantation</atitle><jtitle>BLOOD</jtitle><addtitle>Blood</addtitle><date>2009-01-29</date><risdate>2009</risdate><volume>113</volume><issue>5</issue><spage>1175</spage><epage>1183</epage><pages>1175-1183</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><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.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>18971419</pmid><doi>10.1182/blood-2008-05-158782</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Factors Biological and medical sciences Chronic Disease Female Graft vs Host Disease - mortality Hematologic and hematopoietic diseases Hematopoietic Stem Cell Transplantation Humans Male Medical sciences Neoplasms, Second Primary - etiology Neoplasms, Second Primary - mortality Retrospective Studies Risk Factors Sex Factors Time Factors Transplantation Transplantation Conditioning Transplantation, Homologous Whole-Body Irradiation |
| title | Solid cancers after allogeneic hematopoietic cell transplantation |
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