Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning

Olle Ringdén; Ruta Brazauskas; Zhiwei Wang; Ibrahim Ahmed; Yoshiko Atsuta; David Buchbinder; Linda J. Burns; Jean Yves Cahn; Christine Duncan; Gregory A. Hale; Joerg Halter; Robert J. Hayashi; Jack W. Hsu; David A. Jacobsohn; Rammurti T. Kamble; Naynesh R. Kamani; Kimberly A. Kasow; Nandita Khera; Hillard M. Lazarus; Alison W. Loren; David I. Marks; Kasiani C. Myers; Muthalagu Ramanathan; Wael Saber; Bipin N. Savani; Harry C. Schouten; Gérard Socie; Mohamed L. Sorror; Amir Steinberg; Uday Popat; John R. Wingard; Jonas Mattsson; Navneet S. Majhail

doi:10.1016/j.bbmt.2014.07.009

Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning

Olle Ringdén, Ruta Brazauskas, Zhiwei Wang, Ibrahim Ahmed, Yoshiko Atsuta, David Buchbinder, Linda J. Burns, Jean Yves Cahn, Christine Duncan, Gregory A. Hale, Joerg Halter, Robert J. Hayashi, Jack W. Hsu, David A. Jacobsohn, Rammurti T. Kamble, Naynesh R. Kamani, Kimberly A. Kasow, Nandita Khera, Hillard M. Lazarus, Alison W. LorenDavid I. Marks, Kasiani C. Myers, Muthalagu Ramanathan, Wael Saber, Bipin N. Savani, Harry C. Schouten, Gérard Socie, Mohamed L. Sorror, Amir Steinberg, Uday Popat, John R. Wingard, Jonas Mattsson, Navneet S. Majhail

Hematology/Oncology

Research output: Contribution to journal › Article › peer-review

35 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	1777-1784
Number of pages	8
Journal	Biology of Blood and Marrow Transplantation
Volume	20
Issue number	11
DOIs	https://doi.org/10.1016/j.bbmt.2014.07.009
State	Published - Nov 1 2014

Keywords

Hematopoietic cell transplantation
Nonmyeloablative conditioning
Reduced-intensity conditioning
Second cancers
Solid tumors

ASJC Scopus subject areas

Hematology
Transplantation

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10.1016/j.bbmt.2014.07.009

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Ringdén, O., Brazauskas, R., Wang, Z., Ahmed, I., Atsuta, Y., Buchbinder, D., Burns, L. J., Cahn, J. Y., Duncan, C., Hale, G. A., Halter, J., Hayashi, R. J., Hsu, J. W., Jacobsohn, D. A., Kamble, R. T., Kamani, N. R., Kasow, K. A., Khera, N., Lazarus, H. M., ... Majhail, N. S. (2014). Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning. Biology of Blood and Marrow Transplantation, 20(11), 1777-1784. https://doi.org/10.1016/j.bbmt.2014.07.009

Ringdén, O, Brazauskas, R, Wang, Z, Ahmed, I, Atsuta, Y, Buchbinder, D, Burns, LJ, Cahn, JY, Duncan, C, Hale, GA, Halter, J, Hayashi, RJ, Hsu, JW, Jacobsohn, DA, Kamble, RT, Kamani, NR, Kasow, KA, Khera, N, Lazarus, HM, Loren, AW, Marks, DI, Myers, KC, Ramanathan, M, Saber, W, Savani, BN, Schouten, HC, Socie, G, Sorror, ML, Steinberg, A, Popat, U, Wingard, JR, Mattsson, J & Majhail, NS 2014, 'Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning', Biology of Blood and Marrow Transplantation, vol. 20, no. 11, pp. 1777-1784. https://doi.org/10.1016/j.bbmt.2014.07.009

@article{86c34f1160644359a7e6292de578b751,

title = "Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning",

abstract = "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.",

keywords = "Hematopoietic cell transplantation, Nonmyeloablative conditioning, Reduced-intensity conditioning, Second cancers, Solid tumors",

author = "Olle Ringd{\'e}n and Ruta Brazauskas and Zhiwei Wang and Ibrahim Ahmed and Yoshiko Atsuta and David Buchbinder and Burns, {Linda J.} and Cahn, {Jean Yves} and Christine Duncan and Hale, {Gregory A.} and Joerg Halter and Hayashi, {Robert J.} and Hsu, {Jack W.} and Jacobsohn, {David A.} and Kamble, {Rammurti T.} and Kamani, {Naynesh R.} and Kasow, {Kimberly A.} and Nandita Khera and Lazarus, {Hillard M.} and Loren, {Alison W.} and Marks, {David I.} and Myers, {Kasiani C.} and Muthalagu Ramanathan and Wael Saber and Savani, {Bipin N.} and Schouten, {Harry C.} and G{\'e}rard Socie and Sorror, {Mohamed L.} and Amir Steinberg and Uday Popat and Wingard, {John R.} and Jonas Mattsson and Majhail, {Navneet S.}",

note = "Publisher Copyright: {\textcopyright} 2014 American Society for Blood and Marrow Transplantation.",

year = "2014",

month = nov,

day = "1",

doi = "10.1016/j.bbmt.2014.07.009",

language = "English (US)",

volume = "20",

pages = "1777--1784",

journal = "Biology of Blood and Marrow Transplantation",

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publisher = "Elsevier Inc.",

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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.

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

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SN - 1083-8791

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ER -

Second solid cancers after allogeneic hematopoietic cell transplantation using reduced-intensity conditioning

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