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Solid cancers after bone marrow transplantation
- Source :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 19(2)
- Publication Year :
- 2001
-
Abstract
- PURPOSE: To evaluate the incidence and associated risk factors of solid cancers after bone marrow transplantation (BMT). PATIENTS AND METHODS: We analyzed 2,129 patients who had undergone BMT for hematologic malignancies at the City of Hope National Medical Center between 1976 and 1998. A retrospective cohort and nested case-control study design were used to evaluate the role of pretransplantation therapeutic exposures and transplant conditioning regimens. RESULTS: Twenty-nine patients developed solid cancers after BMT, which represents a two-fold increase in risk compared with a comparable normal population. The estimated cumulative probability (± SE) for development of a solid cancer was 6.1% ± 1.6% at 10 years. The risk was significantly elevated for liver cancer (standardized incidence ratio [SIR], 27.7; 95% confidence interval [CI], 1.9 to 57.3), cancer of the oral cavity (SIR, 17.4; 95% CI, 6.3 to 34.1), and cervical cancer (SIR, 13.3; 95% CI, 3.5 to 29.6). Each of the two patients with liver cancer had a history of chronic hepatitis C infection. All six patients with squamous cell carcinoma of the skin had chronic graft-versus-host disease. The risk was significantly higher for survivors who were younger than 34 years of age at time of BMT (SIR, 5.3; 95% CI, 2.7 to 8.6). Cancers of the thyroid gland, liver, and oral cavity occurred primarily among patients who received total-body irradiation. CONCLUSION: The risk of radiation-associated solid tumor development after BMT is likely to increase with longer follow-up. This underscores the importance of close monitoring of patients who undergo BMT.
- Subjects :
- Oncology
Adult
Male
Cancer Research
medicine.medical_specialty
Transplantation Conditioning
Adolescent
Uterine Cervical Neoplasms
Risk Factors
Internal medicine
medicine
Humans
Thyroid Neoplasms
Risk factor
Child
Aged
Bone Marrow Transplantation
Probability
Retrospective Studies
Cervical cancer
Mouth neoplasm
business.industry
Incidence
Liver Neoplasms
Cancer
Infant
Retrospective cohort study
Neoplasms, Second Primary
Middle Aged
medicine.disease
Surgery
Standardized mortality ratio
Case-Control Studies
Child, Preschool
Hematologic Neoplasms
Female
Mouth Neoplasms
business
Liver cancer
Whole-Body Irradiation
Subjects
Details
- ISSN :
- 0732183X
- Volume :
- 19
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....ae6ebebb09921c6a05e238b76cb6fda5