Survival of patients who develop solid tumors following hematopoietic stem cell transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 51; no. 1; pp. 83 - 88
• Main Authors: Ehrhardt, M J, Brazauskas, R, He, W, Rizzo, J D, Shaw, B E
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.01.2016
• Subjects: Adolescent; Adult; Aged; Bone marrow; Cancer; Care and treatment; Central nervous system; Child; Child, Preschool; Complications and side effects; Confidence intervals; Development and progression; Disease-Free Survival; Female; Follow-Up Studies; Gastrointestinal system; Gastrointestinal tract; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Infant; Male; Melanoma; Middle Aged; Neoplasms, Second Primary - mortality; Neoplasms, Second Primary - pathology; Neoplasms, Second Primary - therapy; Oral cavity; Organ Specificity; Patient outcomes; Retrospective Studies; Risk analysis; Risk factors; Solid tumors; Stem cell transplantation; Stem cells; Survival; Survival Rate; Thyroid; Transplantation; Transplants & implants; Tumors; United States
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2015.203

Allogeneic hematopoietic cell transplantation is associated with late adverse effects of therapy, including secondary solid cancers. Most reports address risk factors; however, outcomes after secondary solid cancer development are incompletely described. Our objective was to estimate survival probabilities for transplant recipients dependent on secondary solid cancer subtype. We used a previously identified and published cohort who developed secondary solid cancers following allogeneic transplant. Follow-up for these 112 previously identified patients was extended and their survival probabilities were studied. Median duration of follow-up from the development of secondary cancer for survivors was 11.9 years (range: 0.8-23.4) and 75% were followed >7.0 years. The 5- and 10-year overall survival probabilities were 50% (95% confidence interval (CI): 41-60) and 46% (95% CI: 37-57), respectively. Overall survival varied by secondary cancer type. Secondary cancer was the cause of death in most patients who died following development of melanoma, central nervous system, oral cavity, thyroid, lung, lower gastrointestinal tract and bone cancers. Extended follow-up allowed for the most comprehensive longitudinal evaluation to date of this rare condition. These findings will enhance clinicians' ability to predict outcomes and counsel transplant survivors who develop secondary solid cancers.