Open AccessSecond cancer risk in adults receiving autologous haematopoietic SCT for cancer: a population-based cohort study
Author(s) -
Ian Bilmon,
Lesley J. Ashton,
Renate E. Le Marsney,
Anthony J. Dodds,
Tracey O’Brien,
Leonie Wilcox,
Ian Nivison-Smith,
Benjamin Daniels,
Claire M. Vajdic,
Lesley J. Ashton,
Renate Le Marsney,
Anthony J. Dodds,
Jiong Hao Tan,
Ian Bilmon,
Leonie Wilcox,
Ian Nivison-Smith,
Donna Aarons,
Steven Tran,
Claire M. Vajdic,
J. B. Gibson,
Atholl Johnston,
Matthew Greenwood,
Matthew Forbes,
Mark Hertzberg,
Guozhong Huang,
Ana Sofia Spencer,
Jenny Muirhead,
Jeffrey Szer,
Kate Mason,
Ian D. Lewis,
Cuong To,
Simon Durrant,
Robyn Western,
Paul Cannell,
Susan Buffery,
Tracey O’Brien,
Cecilia Oswald,
Adam Nelson,
Peter M. Shaw,
Linda Pearson,
Karin Tiedemann,
M. Scoyne,
Christopher Fraser,
J. Seljak,
Charlotte Cole,
K. M. Rowland,
Hannah Gough,
Heather Tapp,
N Green,
Aye Moa,
Jennifer L. McRae,
Mark A. Jenkins,
Jessica Hicks,
Kevin Chaplin
Publication year - 2014
Publication title -
bone marrow transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 127
eISSN - 1476-5365
pISSN - 0268-3369
DOI - 10.1038/bmt.2014.13
Subject(s) - medicine , population , cancer , national death index , cancer registry , oncology , cohort , transplantation , surgery , hazard ratio , confidence interval , environmental health
Population-based evidence on second cancer risk following autologous haematopoietic SCT (HCT) is lacking. We quantified second cancer risk for a national, population-based cohort of adult Australians receiving autologous HCT for cancer and notified to the Australasian Bone Marrow Transplant Recipient Registry 1992-2007 (n=7765). Cancer diagnoses and deaths were ascertained by linkage with the Australian Cancer Database and National Death Index. Standardized incidence ratios (SIRs) were calculated and Cox regression models were used to estimate within-cohort risk factors treating death as a competing risk. During a median 2.5 years follow-up, second cancer risk was modestly increased compared with the general population (SIR 1.4, 95% confidence interval 1.2-1.6); significantly elevated risk was also observed for AML/myelodysplastic syndrome (SIR=20.6), melanoma (SIR=2.6) and non-Hodgkin lymphoma (SIR=3.3). Recipients at elevated risk of any second cancer included males, and those transplanted at a younger age, in an earlier HCT era, or for lymphoma or testicular cancer. Male sex, older age (>45 years) and history of relapse after HCT predicted melanoma risk. Transplantation for Hodgkin lymphoma and older age were associated with lung cancer risk. Second malignancies are an important late effect and these results inform and emphasize the need for cancer surveillance in autologous HCT survivors.