TY - JOUR
T1 - Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning
AU - Ringdén, Olle
AU - Brazauskas, Ruta
AU - Wang, Zhiwei
AU - Ahmed, Ibrahim
AU - Atsuta, Yoshiko
AU - Buchbinder, David
AU - Burns, Linda J.
AU - Cahn, Jean Yves
AU - Duncan, Christine
AU - Hale, Gregory A.
AU - Halter, Joerg
AU - Hayashi, Robert J.
AU - Hsu, Jack W.
AU - Jacobsohn, David A.
AU - Kamble, Rammurti T.
AU - Kamani, Naynesh R.
AU - Kasow, Kimberly A.
AU - Khera, Nandita
AU - Lazarus, Hillard M.
AU - Loren, Alison W.
AU - Marks, David I.
AU - Myers, Kasiani C.
AU - Ramanathan, Muthalagu
AU - Saber, Wael
AU - Savani, Bipin N.
AU - Schouten, Harry C.
AU - Socie, Gérard
AU - Sorror, Mohamed L.
AU - Steinberg, Amir
AU - Popat, Uday
AU - Wingard, John R.
AU - Mattsson, Jonas
AU - Majhail, Navneet S.
N1 - Funding Information:
Financial disclosure: The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases ; Grant/Cooperative Agreement 5U01HL069294 from the NHLBI and National Cancer Institute ; a contract (HHSH234200637015C) with the US Health Resources and Services Administration; 2 grants ( N00014-06-1-0704 and N00014-08-1-0058 ) from the US Office of Naval Research ; and grants from Allos, Inc. ; Amgen, Inc. ; Angioblast ; Anonymous donation to the Medical College of Wisconsin; Ariad Pharmaceuticals ; Be the Match Foundation ; Blue Cross and Blue Shield Association ; The Bailey Family Foundation ; Terumo BCT ; Celgene ; CellGenix ; Children's Leukemia Research Association ; Fresenius-Biotech North America, Inc. ; Gamida Cell Teva Joint Venture Ltd. ; Genentech, Inc. ; Genzyme Corporation ; GlaxoSmithKline ; HistoGenetics, Inc. ; Kiadis Pharma ; The Leukemia & Lymphoma Society ; The Medical College of Wisconsin; Merck & Co, Inc. ; Millennium: The Takeda Oncology Co. ; Milliman USA, Inc. ; Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Optum Healthcare Solutions, Inc. ; Osiris Therapeutics, Inc. ; Otsuka America Pharmaceutical, Inc. ; RemedyMD ; Sanofi; Seattle Genetics; Sigma-Tau Pharmaceuticals ; Soligenix, Inc. ; StemCyte , A Global Cord Blood Therapeutics Co. ; Stemsoft Software, Inc. ; Swedish Orphan Biovitrum ; Tarix Pharmaceuticals ; Teva Neuroscience, Inc. ; Texas Instruments Inc. ; and WellPoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the US Government.
Publisher Copyright:
© 2014 American Society for Blood and Marrow Transplantation.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - 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 60years 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 10years. 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 60years, 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.
AB - 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 60years 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 10years. 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 60years, 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.
KW - Hematopoietic cell transplantation
KW - Nonmyeloablative conditioning
KW - Reduced-intensity conditioning
KW - Second cancers
KW - Solid tumors
UR - http://www.scopus.com/inward/record.url?scp=84908022945&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2014.07.009
DO - 10.1016/j.bbmt.2014.07.009
M3 - Article
C2 - 25042734
AN - SCOPUS:84908022945
VL - 20
SP - 1777
EP - 1784
JO - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
SN - 1083-8791
IS - 11
ER -