Allogeneic HSCT increased risk for oral, esophageal cancers
Allogeneic hematopoietic stem cell transplantation doubled the risk for secondary solid cancers and further increased the risk for oral and esophageal cancers, according to study results.
The increased risk for developing solid tumors after allogeneic HSCT also was associated with graft-versus-host disease (GVHD), results showed.
Researchers sought to analyze the incidence of secondary cancers among HSCT recipients because the number of long-term HSCT survivors has increased in the past 2 decades.
The analysis included 17,545 patients who underwent their first allogeneic HSCT in Japan between 1990 and 2007.
Overall, researchers observed 269 secondary solid cancers among the study population. The cumulative incidence of secondary malignancies increased from 0.7% (95% CI, 0.6-0.9) at 5 years to 1.7% (95% CI, 1.4-1.9) at 10 years post-allogeneic HSCT.
The risk for secondary malignancies was significantly higher among allogeneic HSCT recipients compared with the general population (standardized incidence ratio=1.8; 95% CI, 1.5-2).
When researchers analyzed data by cancer type, they determined risks were highest for oral (SIR=15.7; 95% CI, 12.1-20.1), esophageal (SIR=8.5; 95% CI, 6.1-11.5), colon (SIR=1.9; 95% CI, 1.2-2.7), skin (SIR=7.2; 95% CI, 3.9-12.4) and brain/nervous system cancers (SIR=4.1; 95% CI, 1.6-8.4).
Researchers also found extensive-type chronic GVHD was linked to all secondary solid tumors (RR=1.8; P˂.001), oral cancer (RR=2.9; P˂.001) and esophageal cancer (RR=5.3; P˂.001). Limited-type chronic GVHD was associated with increased risk for skin cancer (RR=5.8; P=.016).
“Lifelong screening of high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD,” the researchers wrote.
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.