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异基因造血干细胞移植后继发性实体恶性肿瘤的风险及预防策略。

Risk of secondary solid malignancies after allogeneic hematopoietic stem cell transplantation and preventive strategies.

作者信息

Adhikari Janak, Sharma Priyadarshani, Bhatt Vijaya Raj

机构信息

Department of Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.

Division of Hematology-Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

Future Oncol. 2015;11(23):3175-85. doi: 10.2217/fon.15.252. Epub 2015 Nov 9.

Abstract

The risk of secondary solid malignancies is increased after allogeneic hematopoietic stem cell transplantation (HSCT). The risk starts at about 10 years after HSCT and continues even 20 years later. The most common secondary malignancies include squamous cell carcinoma of skin, genitourinary tract and oral cavity; lung and breast cancers. The use of total body irradiation or conditioning chemotherapy, chronic graft-versus-host disease and duration since HSCT can influence the risk of secondary solid malignancies. Secondary solid malignancies are common causes of nonrelapse mortality in long-term survivors and may account for up to 10% of late deaths. Avoiding smoking, alcohol use and excess sun exposure may reduce the risk. Cancer prevention guidelines are largely consensus-driven and follow the recommendations for general population.

摘要

异基因造血干细胞移植(HSCT)后,继发性实体恶性肿瘤的风险会增加。这种风险在HSCT后约10年开始出现,甚至在20年后仍会持续。最常见的继发性恶性肿瘤包括皮肤、泌尿生殖道和口腔的鳞状细胞癌;肺癌和乳腺癌。全身照射或预处理化疗的使用、慢性移植物抗宿主病以及HSCT后的持续时间会影响继发性实体恶性肿瘤的风险。继发性实体恶性肿瘤是长期存活者非复发死亡的常见原因,可能占晚期死亡人数的10%。避免吸烟、饮酒和过度日晒可能会降低风险。癌症预防指南在很大程度上是由共识驱动的,并遵循针对普通人群的建议。

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