New research has recently revealed there could be higher risk associated with the development of secondary solid cancers, oral cancers and esophageal cancers after receiving a treatment called allogeneic hematopoietic stem cell transplantation (allogeneic HSCT).
HSCT, which involves the transplantation of multi potent hematopoietic stem cells into recipients that are extracted from bone marrow, peripheral blood, or umbilical cord blood, is regarded as a dangerous and complicated treatment that is typically reserved for blood or bone cancer patients whose immune systems have been virtually eviscerated from cancer treatments like radiation and chemotherapy. While the treatment can be effective in helping to restore immune function, it also runs the risk of giving rise to serious complications. Specifically, Allogeneic HSCT, which involves two people — a donor and a recipient — has recently been found in to pose an elevated risk of the development of solid cancers associated with graft-versus-host disease (GVHD), which is a disease the donor tissues attack the tissues of the recipient.
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The article outlining the study was recently published in the journal Annals of Oncology, titled “Continuing increased risk of oral/esophageal cancer after allogeneic hematopoietic stem cell transplantation in adults in association with chronic graft-versus-host disease” (dpi:10.1093/annonc/mdt558.). As part of the study, researchers analyzed 17,545 patients who received allogeneic HSCT in Japan between 1990 and 2007.Among this group, 269 secondary solid cancers were observed among all of the patients involved in the study. The cumulative incidence of secondary malignancies increased from 0.7% at 5 years to 1.7% at 10 years after receiving the allogeneic HSCT treatment. In addition, the risk of secondary solid cancers was significantly higher among the patients compared with the general population (standardized incidence ratio (SIR)=1.8; 95% CI, 1.5-2).
The researchers determined that allogeneic HSCT recipients had the highest risk of developing oral cancers (SIR=15.7; 95% CI, 12.1-20.1), followed by 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 cancers (SIR=4.1; 95% CI, 1.6-8.4). All types of these cancers were found to be associated with extensive-type chronic GVHD.
“Lifelong screening of high-risk organ sites, especially oral or esophageal cancers, is important for recipients with active, or a history of, chronic GVHD,” the researchers wrote. As a result of this new study, going forward, medical practitioners will need to weigh the need for administering allogeneic HSCT to cancer patients against the prospect of an increased prevalence of GVHD as an unintended consequence of the disease.