Secondary solid cancer following hematopoietic cell transplantation in patients with thalassemia major

• Published in: Bone marrow transplantation (Basingstoke) 2018-01, Vol.53 (1), p.39-43
• Main Authors: Santarone, S, Pepe, A, Meloni, A, Natale, A, Pistoia, L, Olioso, P, Papalinetti, G, Cuccia, L, Spasiano, A, Lisi, R, Di Ianni, M, Bonfini, T, Accorsi, P, Salvadori, S, Papola, F, Angelini, S, Di Bartolomeo, P
• Format: Article
• Language: English
• Subjects: 692/308; 692/308/174; beta-Thalassemia - complications; Cancer; Care and treatment; Cell Biology; Complications and side effects; Development and progression; Female; Health aspects; Health risks; Hematology; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Incidence; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms, Second Primary - etiology; Neoplasms, Second Primary - pathology; original-article; Patient outcomes; Patients; Public Health; Risk factors; Stem cell transplantation; Stem Cells; Thalassemia; Transplantation; Transplantation Conditioning - adverse effects; Transplants & implants
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2017.214

Hematopoietic cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers (SSCs). The aim of this retrospective study was to compare the incidence of SSC in a monocentric cohort of thalassemia major (TM) patients ( n =122) who received HCT versus an hematopoietic cell donor monocentric cohort ( n =122) and versus a large multicenter cohort of age- and sex-matched TM patients ( n =244) who received conventional therapy. With a median follow-up of 24 years, 8 transplanted patients were diagnosed with SSC at a median of 18 years after HCT and at a median age of 33 years. Three patients died of cancer progression and 5 are living after a follow-up ranging from 10 months to 16 years after SSC diagnosis. The 30-year cumulative incidence of developing SSC was 13.24%. The occurrence of solid cancers in the hematopoietic cell donor cohort was limited to only one case for a significantly lower cumulative incidence (3.23%, P =0.02) and to 3 cases in the cohort of nontransplant patients for a significantly lower cumulative incidence (1.32%, P =0.005). This study shows that the magnitude of increased risk of SST is fourfold to sixfold for patients treated with HCT as compared with hematopoietic cell donors and nontransplant patients.