Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease

Y. Atsuta, R. Suzuki, T. Yamashita, T. Fukuda, K. Miyamura, S. Taniguchi, H. Iida, T. Uchida, K. Ikegame, S. Takahashi, K. Kato, K. Kawa, T. Nagamura-Inoue, Y. Morishima, H. Sakamaki, Y. Kodera

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    Abstract

    Background: The number of long-term survivors after hematopoietic stem cell transplantation (HSCT) showed steady increase in the past two decades. Second malignancies after HSCT are a devastating late complication. We analyzed the incidence of, risk compared with that in the general population, and risk factors for secondary solid cancers. Patients and methods: Patients were 17 545 adult recipients of a first allogeneic stem cell transplantation between 1990 and 2007 in Japan. Risks of developing secondary solid tumors were compared with general population by using standard incidence ratios (SIRs). Results: Two-hundred sixty-nine secondary solid cancers were identified. The cumulative incidence was 0.7% [95% confidence interval (CI), 0.6%-0.9%] at 5 years and 1.7% (95% CI, 1.4%-1.9%) at 10 years after transplant. The risk was significantly higher than that in the general population (SIR = 1.8, 95% CI, 1.5-2.0). Risk was higher for oral cancer (SIR = 15.7, 95% CI, 12.1-20.1), esophageal cancer (SIR = 8.5, 95% CI, 6.1-11.5), colon cancer (SIR = 1.9, 95% CI, 1.2-2.7), skin cancer (SIR = 7.2, 95% CI, 3.9-12.4), and brain/nervous system cancer (SIR = 4.1, 95% CI, 1.6-8.4). The risk of developing oral, esophageal, or skin cancer was higher at all times after 1-year post-transplant. Extensive-type chronic graft-versus-host disease (GVHD) was a significant risk factor for the development of all solid tumors (RR = 1.8, P < 0.001), as well as for oral (RR = 2.9, P < 0.001) and esophageal (RR = 5.3, P < 0.001) cancers. Limited-type chronic GVHD was an independent risk factor for skin cancers (RR = 5.8, P = 0.016). Conclusion: Recipients of allogeneic HSCT had a significantly higher ̃2-fold risk of developing secondary solid cancers than the general population. Lifelong screening for high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD.

    Original languageEnglish
    Pages (from-to)435-441
    Number of pages7
    JournalAnnals of Oncology
    Volume25
    Issue number2
    DOIs
    Publication statusPublished - Feb 2014

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    Mouth Neoplasms
    Hematopoietic Stem Cell Transplantation
    Graft vs Host Disease
    Esophageal Neoplasms
    Confidence Intervals
    Incidence
    Skin Neoplasms
    Neoplasms
    Population
    Transplants
    Second Primary Neoplasms
    Stem Cell Transplantation
    Colonic Neoplasms
    Nervous System
    Survivors
    Japan
    Brain

    All Science Journal Classification (ASJC) codes

    • Hematology
    • Oncology

    Cite this

    Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease. / Atsuta, Y.; Suzuki, R.; Yamashita, T.; Fukuda, T.; Miyamura, K.; Taniguchi, S.; Iida, H.; Uchida, T.; Ikegame, K.; Takahashi, S.; Kato, K.; Kawa, K.; Nagamura-Inoue, T.; Morishima, Y.; Sakamaki, H.; Kodera, Y.

    In: Annals of Oncology, Vol. 25, No. 2, 02.2014, p. 435-441.

    Research output: Contribution to journalArticle

    Atsuta, Y, Suzuki, R, Yamashita, T, Fukuda, T, Miyamura, K, Taniguchi, S, Iida, H, Uchida, T, Ikegame, K, Takahashi, S, Kato, K, Kawa, K, Nagamura-Inoue, T, Morishima, Y, Sakamaki, H & Kodera, Y 2014, 'Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease', Annals of Oncology, vol. 25, no. 2, pp. 435-441. https://doi.org/10.1093/annonc/mdt558
    Atsuta, Y. ; Suzuki, R. ; Yamashita, T. ; Fukuda, T. ; Miyamura, K. ; Taniguchi, S. ; Iida, H. ; Uchida, T. ; Ikegame, K. ; Takahashi, S. ; Kato, K. ; Kawa, K. ; Nagamura-Inoue, T. ; Morishima, Y. ; Sakamaki, H. ; Kodera, Y. / Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease. In: Annals of Oncology. 2014 ; Vol. 25, No. 2. pp. 435-441.
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    title = "Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease",
    abstract = "Background: The number of long-term survivors after hematopoietic stem cell transplantation (HSCT) showed steady increase in the past two decades. Second malignancies after HSCT are a devastating late complication. We analyzed the incidence of, risk compared with that in the general population, and risk factors for secondary solid cancers. Patients and methods: Patients were 17 545 adult recipients of a first allogeneic stem cell transplantation between 1990 and 2007 in Japan. Risks of developing secondary solid tumors were compared with general population by using standard incidence ratios (SIRs). Results: Two-hundred sixty-nine secondary solid cancers were identified. The cumulative incidence was 0.7{\%} [95{\%} confidence interval (CI), 0.6{\%}-0.9{\%}] at 5 years and 1.7{\%} (95{\%} CI, 1.4{\%}-1.9{\%}) at 10 years after transplant. The risk was significantly higher than that in the general population (SIR = 1.8, 95{\%} CI, 1.5-2.0). Risk was higher for oral cancer (SIR = 15.7, 95{\%} CI, 12.1-20.1), esophageal cancer (SIR = 8.5, 95{\%} CI, 6.1-11.5), colon cancer (SIR = 1.9, 95{\%} CI, 1.2-2.7), skin cancer (SIR = 7.2, 95{\%} CI, 3.9-12.4), and brain/nervous system cancer (SIR = 4.1, 95{\%} CI, 1.6-8.4). The risk of developing oral, esophageal, or skin cancer was higher at all times after 1-year post-transplant. Extensive-type chronic graft-versus-host disease (GVHD) was a significant risk factor for the development of all solid tumors (RR = 1.8, P < 0.001), as well as for oral (RR = 2.9, P < 0.001) and esophageal (RR = 5.3, P < 0.001) cancers. Limited-type chronic GVHD was an independent risk factor for skin cancers (RR = 5.8, P = 0.016). Conclusion: Recipients of allogeneic HSCT had a significantly higher ̃2-fold risk of developing secondary solid cancers than the general population. Lifelong screening for high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD.",
    author = "Y. Atsuta and R. Suzuki and T. Yamashita and T. Fukuda and K. Miyamura and S. Taniguchi and H. Iida and T. Uchida and K. Ikegame and S. Takahashi and K. Kato and K. Kawa and T. Nagamura-Inoue and Y. Morishima and H. Sakamaki and Y. Kodera",
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    language = "English",
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    pages = "435--441",
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    TY - JOUR

    T1 - Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease

    AU - Atsuta, Y.

    AU - Suzuki, R.

    AU - Yamashita, T.

    AU - Fukuda, T.

    AU - Miyamura, K.

    AU - Taniguchi, S.

    AU - Iida, H.

    AU - Uchida, T.

    AU - Ikegame, K.

    AU - Takahashi, S.

    AU - Kato, K.

    AU - Kawa, K.

    AU - Nagamura-Inoue, T.

    AU - Morishima, Y.

    AU - Sakamaki, H.

    AU - Kodera, Y.

    PY - 2014/2

    Y1 - 2014/2

    N2 - Background: The number of long-term survivors after hematopoietic stem cell transplantation (HSCT) showed steady increase in the past two decades. Second malignancies after HSCT are a devastating late complication. We analyzed the incidence of, risk compared with that in the general population, and risk factors for secondary solid cancers. Patients and methods: Patients were 17 545 adult recipients of a first allogeneic stem cell transplantation between 1990 and 2007 in Japan. Risks of developing secondary solid tumors were compared with general population by using standard incidence ratios (SIRs). Results: Two-hundred sixty-nine secondary solid cancers were identified. The cumulative incidence was 0.7% [95% confidence interval (CI), 0.6%-0.9%] at 5 years and 1.7% (95% CI, 1.4%-1.9%) at 10 years after transplant. The risk was significantly higher than that in the general population (SIR = 1.8, 95% CI, 1.5-2.0). Risk was higher for oral cancer (SIR = 15.7, 95% CI, 12.1-20.1), esophageal cancer (SIR = 8.5, 95% CI, 6.1-11.5), colon cancer (SIR = 1.9, 95% CI, 1.2-2.7), skin cancer (SIR = 7.2, 95% CI, 3.9-12.4), and brain/nervous system cancer (SIR = 4.1, 95% CI, 1.6-8.4). The risk of developing oral, esophageal, or skin cancer was higher at all times after 1-year post-transplant. Extensive-type chronic graft-versus-host disease (GVHD) was a significant risk factor for the development of all solid tumors (RR = 1.8, P < 0.001), as well as for oral (RR = 2.9, P < 0.001) and esophageal (RR = 5.3, P < 0.001) cancers. Limited-type chronic GVHD was an independent risk factor for skin cancers (RR = 5.8, P = 0.016). Conclusion: Recipients of allogeneic HSCT had a significantly higher ̃2-fold risk of developing secondary solid cancers than the general population. Lifelong screening for high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD.

    AB - Background: The number of long-term survivors after hematopoietic stem cell transplantation (HSCT) showed steady increase in the past two decades. Second malignancies after HSCT are a devastating late complication. We analyzed the incidence of, risk compared with that in the general population, and risk factors for secondary solid cancers. Patients and methods: Patients were 17 545 adult recipients of a first allogeneic stem cell transplantation between 1990 and 2007 in Japan. Risks of developing secondary solid tumors were compared with general population by using standard incidence ratios (SIRs). Results: Two-hundred sixty-nine secondary solid cancers were identified. The cumulative incidence was 0.7% [95% confidence interval (CI), 0.6%-0.9%] at 5 years and 1.7% (95% CI, 1.4%-1.9%) at 10 years after transplant. The risk was significantly higher than that in the general population (SIR = 1.8, 95% CI, 1.5-2.0). Risk was higher for oral cancer (SIR = 15.7, 95% CI, 12.1-20.1), esophageal cancer (SIR = 8.5, 95% CI, 6.1-11.5), colon cancer (SIR = 1.9, 95% CI, 1.2-2.7), skin cancer (SIR = 7.2, 95% CI, 3.9-12.4), and brain/nervous system cancer (SIR = 4.1, 95% CI, 1.6-8.4). The risk of developing oral, esophageal, or skin cancer was higher at all times after 1-year post-transplant. Extensive-type chronic graft-versus-host disease (GVHD) was a significant risk factor for the development of all solid tumors (RR = 1.8, P < 0.001), as well as for oral (RR = 2.9, P < 0.001) and esophageal (RR = 5.3, P < 0.001) cancers. Limited-type chronic GVHD was an independent risk factor for skin cancers (RR = 5.8, P = 0.016). Conclusion: Recipients of allogeneic HSCT had a significantly higher ̃2-fold risk of developing secondary solid cancers than the general population. Lifelong screening for high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD.

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    DO - 10.1093/annonc/mdt558

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    JO - Annals of Oncology

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