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Long-term follow-up of secondary malignancies in adults after allogeneic bone marrow transplantation

2004; Springer Nature; Volume: 35; Issue: 1 Linguagem: Inglês

10.1038/sj.bmt.1704706

1476-5365

Wanda Hasegawa, Gregory R. Pond, Joshua Rifkind, Hans A. Messner, Anthea Lau, Andrew Daly, Thomas Kiss, Natallia Kotchetkova, Alia Galal, J. H. Lipton,

Nonmelanoma Skin Cancer Studies

The purpose of this study was to evaluate the estimated incidence of secondary malignancies post-allogeneic bone marrow transplantation (BMT) in a cohort of adult patients previously reported now with an additional 8.5 years of follow-up. A cohort of 557 patients older than age 16 years underwent allogeneic BMT between June 1970 and November 1993. Histologic reports confirmed the diagnosis of a secondary malignancy. Multivariate Cox proportional hazards method was utilized to investigate predictors for the development of secondary malignancies. In all, 31 patients in this cohort developed a secondary malignancy a median of 6.79 years after their transplant. The estimated cumulative incidence rate of secondary malignancy was 4.2% at 10 years post transplant. When compared to the general population, the estimated observed/expected ratio of new cancer diagnoses was 5.13. On multivariate analysis, older age at the time of transplant was the only significant predictor for development of secondary cancer (P=0.01). The most common malignancies observed were nonmelanomatous skin cancers and squamous cell cancers of the buccal cavity. The risk of developing a secondary malignancy after allogeneic BMT is significant, particularly in older patients. Long-term survivors of transplant require regular monitoring for early signs of cancer, particularly of the skin and oral cavity.