Bone Marrow Transplant Center, Department of Hematology, Transfusion Center and Biotechnology, Ospedale Civile, Pescara, Italy.
Magnetic Resonance Imaging Unit, Fondazione G. Monasterio, CNR-Regione Toscana, Pisa, Italy.
Bone Marrow Transplant. 2018 Jan;53(1):39-43. doi: 10.1038/bmt.2017.214. Epub 2017 Oct 9.
Hematopoietic cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers (SSCs). The aim of this retrospective study was to compare the incidence of SSC in a monocentric cohort of thalassemia major (TM) patients (n=122) who received HCT versus an hematopoietic cell donor monocentric cohort (n=122) and versus a large multicenter cohort of age- and sex-matched TM patients (n=244) who received conventional therapy. With a median follow-up of 24 years, 8 transplanted patients were diagnosed with SSC at a median of 18 years after HCT and at a median age of 33 years. Three patients died of cancer progression and 5 are living after a follow-up ranging from 10 months to 16 years after SSC diagnosis. The 30-year cumulative incidence of developing SSC was 13.24%. The occurrence of solid cancers in the hematopoietic cell donor cohort was limited to only one case for a significantly lower cumulative incidence (3.23%, P=0.02) and to 3 cases in the cohort of nontransplant patients for a significantly lower cumulative incidence (1.32%, P=0.005). This study shows that the magnitude of increased risk of SST is fourfold to sixfold for patients treated with HCT as compared with hematopoietic cell donors and nontransplant patients.
造血细胞移植（HCT）受者发生继发性实体瘤（SSC）的风险很大。本回顾性研究的目的是比较在接受 HCT 的单中心地中海贫血（TM）患者队列（n=122）、单中心造血细胞供者队列（n=122）和接受常规治疗的年龄和性别匹配的大型多中心 TM 患者队列（n=244）中 SSC 的发生率。中位随访 24 年后，8 例移植患者在 HCT 后中位 18 年、中位年龄 33 岁时被诊断为 SSC。3 例患者死于癌症进展，5 例患者在 SSC 诊断后 10 个月至 16 年的随访期间仍存活。30 年累积 SSC 发生率为 13.24%。造血细胞供者队列中实体癌的发生仅限于 1 例，累积发生率明显较低（3.23%，P=0.02），而非移植患者队列中发生 3 例，累积发生率明显较低（1.32%，P=0.005）。这项研究表明，与造血细胞供者和非移植患者相比，接受 HCT 治疗的患者 SSC 的风险增加了 4 到 6 倍。
