Originally published as JCO Early Release 10.1200/JCO.2005.02.7052 on February 6 2006

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leisenring, W. Articles by Deeg, H. J. Search for Related Content PubMed PubMed Citation Articles by Leisenring, W. Articles by Deeg, H. J.

Nonmelanoma Skin and Mucosal Cancers After Hematopoietic Cell Transplantation

From the Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA

Address reprint requests to Wendy Leisenring, ScD, Clinical Statistics, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, D5-360, PO Box 19024, Seattle, WA 98109; e-mail: wleisenr{at}fhcrc.org

PURPOSE: To evaluate the incidence of and risk factors for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in survivors of hematopoietic cell transplantation (HCT).

PATIENTS AND METHODS: The impact of patient-, disease-, treatment-, and toxicity-related factors on risk of BCC and SCC was determined in a retrospective cohort study of 4,810 patients who received allogeneic HCT and who survived for at least 100 days.

RESULTS: Among allogeneic HCT recipients, 237 developed at least one skin or mucosal cancer (BCC, n = 158; SCC, n = 95). Twenty-year cumulative incidences of BCC and SCC were 6.5% and 3.4%, respectively. Total-body irradiation was a significant risk factor for BCC (P = .003), most strongly among patients younger than 18 years old at HCT (P = .02, interaction). Light-skinned patients had an increased risk of BCC (P = .01). Acute graft-versus-host disease (GVHD) increased the risk of SCC (P = .02), whereas chronic GVHD increased the risk of both BCC (P = .01) and SCC (P < .001).

CONCLUSION: This analysis suggests that immutable factors, such as age and complexion, have a significant impact on BCC and SCC. However, specific treatment (radiotherapy) and transplantation complications (GVHD) may modify that risk. These additional risk factors suggest the contribution of immunologic mechanism DNA and tissue repair in the development of BCC and SCC. We confirm previous reports that exposure to ionizing radiation increases the risk of BCC but not SCC. Survivors of HCT should be monitored for the development of BCC and SCC and use preventive strategies.

Supported by Grants No. HL36444, CA18029, CA102542, and CA15704 from the National Institutes of Health, Bethesda, MD and Grant No. DE-FG03-003462908 from the Low Dose Radiation Research Program, Biological and Environmental Research, US Department of Energy.

Presented in part at the 45th Annual Meeting of the American Society of Hematology, San Diego, CA, December 6-9, 2003.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

This article has been cited by other articles:

				D. L. Friedman, A. Rovo, W. Leisenring, A. Locasciulli, M. E. D. Flowers, A. Tichelli, J. E. Sanders, H. J. Deeg, and G. Socie Increased risk of breast cancer among survivors of allogeneic hematopoietic cell transplantation: a report from the FHCRC and the EBMT-Late Effect Working Party Blood, January 15, 2008; 111(2): 939 - 944. [Abstract] [Full Text] [PDF]