Division of Cancer Epidemiology and Genetics, National Institutes of Health, Department of Health and Human Services, National Cancer Institute, Bethesda, MD.
Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN.
Blood Adv. 2024 Aug 13;8(15):4102-4112. doi: 10.1182/bloodadvances.2024012693.
Compared with the general population, hematopoietic cell transplantation (HCT) survivors are at elevated risk for developing solid subsequent neoplasms (SNs). The Center for International Blood and Marrow Transplant Research (CIBMTR) is a key resource for quantifying solid SN incidence following HCT, but the completeness of SN ascertainment is uncertain. Within a cohort of 18 450 CIBMTR patients linked to the California Cancer Registry (CCR), we evaluated the completeness of solid SN data reported to the CIBMTR from 1991 to 2018 to understand the implications of using CIBMTR data alone or combined with CCR data to quantify the burden of solid SNs after HCT. We estimated the cumulative incidence of developing a solid SN, accounting for the competing risk of death. Within the cohort, solid SNs were reported among 724 patients; 15.6% of these patients had an SN reported by CIBMTR only, 36.9% by CCR only, and 47.5% by both. The corresponding cumulative incidence of developing a solid SN at 10 years following a first HCT was 4.0% (95% confidence interval [CI], 3.5-4.4) according to CIBMTR data only, 5.3% (95% CI, 4.9-5.9) according to CCR data only, and 6.3% (95% CI, 5.7-6.8) according to both sources combined. The patterns were similar for allogeneic and autologous HCT recipients. Linking detailed HCT information from CIBMTR with comprehensive SN data from cancer registries provides an opportunity to optimize SN ascertainment for informing follow-up care practices and evaluating risk factors in the growing population of HCT survivors.
与普通人群相比,造血细胞移植(HCT)幸存者发生实体继发肿瘤(SN)的风险增加。国际血液和骨髓移植研究中心(CIBMTR)是量化 HCT 后实体 SN 发生率的重要资源,但 SN 确定的完整性不确定。在与加利福尼亚癌症登记处(CCR)链接的 18450 名 CIBMTR 患者队列中,我们评估了从 1991 年到 2018 年向 CIBMTR 报告的实体 SN 数据的完整性,以了解单独使用 CIBMTR 数据或结合 CCR 数据来量化 HCT 后实体 SN 负担的影响。我们估计了发展实体 SN 的累积发生率,同时考虑到死亡的竞争风险。在队列中,有 724 名患者报告了实体 SN;其中 15.6%的患者仅由 CIBMTR 报告,36.9%仅由 CCR 报告,47.5%由两者共同报告。根据 CIBMTR 数据,首次 HCT 后 10 年发展实体 SN 的相应累积发生率为 4.0%(95%置信区间[CI],3.5-4.4),仅根据 CCR 数据为 5.3%(95%CI,4.9-5.9),根据两者的综合数据为 6.3%(95%CI,5.7-6.8)。对于同种异体和自体 HCT 受者,这些模式相似。将 CIBMTR 的详细 HCT 信息与癌症登记处的全面 SN 数据相链接,为优化 SN 确定提供了机会,从而为通知后续护理实践和评估不断增长的 HCT 幸存者人群的风险因素提供了机会。