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Subsequent malignancies after allogeneic hematopoietic stem cell transplantation
Author(s) -
Gündüz Mehmet,
Özen Mehmet,
Şahin Uğur,
Toprak Selami Koçak,
Civriz Bozdağ Sinem,
Kurt Yüksel Meltem,
Arslan Önder,
Özcan Muhit,
Demirer Taner,
Beksaç Meral,
İlhan Osman,
Gürman Günhan,
Topçuoğlu Pervin
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12987
Subject(s) - medicine , malignancy , cumulative incidence , hematopoietic stem cell transplantation , transplantation , incidence (geometry) , lymphoproliferative disorders , gastroenterology , graft versus host disease , complication , lymphoma , physics , optics
We evaluated 979 patients for the development of post‐transplant lymphoproliferative disease ( PTLD ) and solid malignancies after allogeneic hematopoietic stem cell transplantations (allo‐ HSCT ) as a late complication. We found 15 (1.5%) subsequent malignancies; three of these malignancies were PTLD , and twelve were solid tumors. The median time from allo‐ HSCT to the development of PTLD was 9 (3‐20) months and that from allo‐ HSCT to the development of solid tumors was 93 (6‐316) months. The cumulative incidence of evolving subsequent malignancy in patients was 1.3% (±0.5 SE) at 5 years and 3.9% (±1.2 SE) at 10 years. The cumulative incidence of developing subsequent malignancy in patients with benign hematological diseases as the transplant indication was 7.4%±4.2 SE at 5 years. More subsequent malignancy developed in patients having ≥1 year chronic graft‐vs‐host disease ( GVHD ; 3.7% in ≥1 year chronic GVHD and 0.7% in <1 year chronic GVHD patient groups, P =.002). Subsequent epithelial tumor risk was higher in ≥1 year chronic GVHD patients than <1 year (3.7% vs 0.1%, P <.001). In multivariate analysis, benign hematological diseases as transplant indication ( RR : 5.6, CI 95%: 1.4‐22.3, P =.015) and ≥1 year chronic GVHD ( RR : 7.1, 95% CI : 2.3‐22.5, P =.001) were associated with the development of subsequent malignancy.