Although stem cell therapies are often thought of as futuristic cures for disease, the first stem cell therapy — hematopoietic stem cell transplantation (HSCT) — has been increasingly used within the past three decades worldwide. Progress in survivorship has been made since the first HSCT, but survivors are shown to have a two- to three-fold increased risk of developing secondary malignancies. Risk factors of new solid cancers, a specific subset of secondary malignancies, include radiation exposure during the conditioning regimen and chronic graft-versus-host disease (GVHD) that results from the allogeneic transfer of cells.
Researchers from various centers in Japan, including lead author Dr. Yoshiko Atsuta from the Nagoya University Graduate School of Medicine, collected data from 17,545 adult patients who received an allogeneic HSCT between the years of 1990 and 2007 in Japan. Within this population, 269 secondary solid cancers were identified; the standard incidence ratio for developing a tumor was 1.8 in the HSCT sample compared to the general population. HSCT patients were most at risk for developing oral and esophageal cancers at all times after one-year post-transplant. Extensive-type GVHD was especially associated with an enhanced risk of oral and esophageal cancers, whereas limited-type chronic GVHD was a risk more for skin cancers.
After looking at the results, the research team determined that “lifelong screening for high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD.” The results were published in Annals of Oncology.
This work was supported by Grants-in-Aid for Scientific Research for Young Scientists B (19790714 and 23791077) from the Japanese Ministry of Education, Culture, Sports, Science and Technology.