Secondary solid cancer screening following hematopoietic cell transplantation

Abstract

Hematopoietic stem cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers, particularly beyond 5 years after HCT and without reaching a plateau overtime. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to facilitate implementation of cancer screening appropriate to HCT recipients. The working group reviewed guidelines and methods for cancer screening applicable to the general population and reviewed the incidence and risk factors for secondary cancers after HCT. A consensus approach was used to establish recommendations for individual secondary cancers. The most common sites include oral cavity, skin, breast and thyroid. Risks of cancers are increased after HCT compared with the general population in skin, thyroid, oral cavity, esophagus, liver, nervous system, bone and connective tissues. Myeloablative TBI, young age at HCT, chronic GVHD and prolonged immunosuppressive treatment beyond 24 months were well-documented risk factors for many types of secondary cancers. All HCT recipients should be advised of the risks of secondary cancers annually and encouraged to undergo recommended screening based on their predisposition. Here we propose guidelines to help clinicians in providing screening and preventive care for secondary cancers among HCT recipients.

Comparison of graft-versus-host disease-free, relapse-free survival according to a variety of graft sources: antithymocyte globulin and single cord blood provide favorable outcomes in some subgroups

“…Previous studies found that chronic GvHD was a major factor associated with risk of secondary solid cancer. [19][20][21][22] Although the absence of significant GvHD may not be a long-term goal, particularly for patients with high-risk disease, the relationship among graft sources remained similar even in the weighted analyses. These results favor the use of bone marrow graft for sibling HCT to promote ideal recovery of patients without significant morbidity in the Japanese population.…”

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Subsequent Neoplasms Working Group Report

“…197 Consensus-based recommendations for screening and prevention of solid cancers were adapted from those for the general population through collaboration of the CIBMTR Late Effects and Quality of Life Working Committee and the EBMT Complications and Quality of Life Working Party for children and adults. 198 …”

Stem cell technology and engineering for cancer treatment

“…High doses chemotherapy and radiation therapy with SCT is also used for patients with solid tumors such as metastatic renal cell cancer (Burk, 2001), advanced ovarian cancer , breast cancer (Garcia-Rayo et al, 2001), testicular cancer (Voss, Feldman, & Motzer, 2012) brain tumor (Dunkel & Finlay, 2002), Wilm's tumor (Kosmas et al, 2010). However, recently studies observed survival SCT patients for 20 years has shown that SCT recipients have a substantial risk of developing solid secondary cancers five years after SCT (Inamoto et al, 2015). The secondary cancers include the skin, thyroid, oral cavity, esophagus, liver, brain, bone, and connective tissue.…”