Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca contra la Leucèmia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca contra la Leucèmia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
Med Clin (Barc). 2018 Jun 8;150(11):421-427. doi: 10.1016/j.medcli.2017.07.004. Epub 2017 Sep 2.
Patients submitted to haematopoietic stem cell transplantation (HSCT) are at increased risk of late complications, such as second neoplasm (SN). The incidence and risk factors of SN in patients receiving HSCT at a single centre were analysed.
The follow-up of adult patients who received a first HSCT (autologous [auto-HSCT] or allogeneic [allo-HSCT]) between January 2000 and December 2015 was reviewed. We collected their demographic characteristics, the primary disease and type of HSCT, and analysed the cumulative incidence of SN and their risk factors.
Of 699 transplanted patients (auto-HSCT, n=451; allo-HSCT, n=248), 42 (6%) developed SN (17 haematological and 25 solid), 31 post-auto-HSCT and 11 post-allo-HSCT. Haematologic SN were more frequent after auto-HSCT than after allo-HSCT. The median time between HSCT and SN was 4.09 years [range 0.07-13.15], with no differences between auto-HSCT and allo-HSCT. The cumulative incidence of SN was 5% (95% CI 3-6) at 5 years, 7% (95% CI 5-10) at 10 years and 11% (95% CI 8-15) at 15 years, without differences according to the type of HSCT. Only the age over 40 years correlated with an increased risk of SN.
In this series, the incidence of post-HSCT SN was similar to that previously described. Patients submitted to an auto-HSCT showed a higher frequency of haematologic SN. A higher incidence of SN was detected in patients older than 40 at the time of HSCT.
接受造血干细胞移植（HSCT）的患者发生晚期并发症（如第二肿瘤[SN]）的风险增加。本研究分析了单中心接受 HSCT 的患者发生 SN 的发病率和危险因素。
对 2000 年 1 月至 2015 年 12 月期间接受首次 HSCT（自体[auto-HSCT]或异体[allo-HSCT]）的成年患者进行了随访。收集了患者的人口统计学特征、原发疾病和 HSCT 类型，并分析了 SN 的累积发生率及其危险因素。
在 699 例接受移植的患者中（auto-HSCT 451 例，allo-HSCT 248 例），有 42 例（6%）发生了 SN（17 例血液系统和 25 例实体瘤），31 例发生于 auto-HSCT 后，11 例发生于 allo-HSCT 后。与 allo-HSCT 相比，auto-HSCT 后发生血液系统 SN 的频率更高。HSCT 与 SN 之间的中位时间为 4.09 年（范围 0.07-13.15），auto-HSCT 和 allo-HSCT 之间无差异。SN 的累积发生率为 5 年时 5%（95%CI 3-6），10 年时 7%（95%CI 5-10），15 年时 11%（95%CI 8-15），与 HSCT 类型无关。仅年龄超过 40 岁与 SN 风险增加相关。
在本系列中，HSCT 后 SN 的发生率与之前描述的相似。接受 auto-HSCT 的患者发生血液系统 SN 的频率更高。HSCT 时年龄大于 40 岁的患者 SN 发生率更高。
