دورية أكاديمية
Secondary Neoplasms After Hematopoietic Cell Transplant for Sickle Cell Disease.
العنوان: | Secondary Neoplasms After Hematopoietic Cell Transplant for Sickle Cell Disease. |
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المؤلفون: | Eapen M; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI., Brazauskas R; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI., Williams DA; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA., Walters MC; University of California San Francisco Benioff Children's Hospital, Oakland, CA., St Martin A; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI., Jacobs BL; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI., Antin JH; Dana-Farber Cancer Center, Harvard Medical School, Boston, MA., Bona K; Dana-Farber Cancer Center, Harvard Medical School, Boston, MA., Chaudhury S; Ann and Robert H. Lurie Children's Hospital, Chicago, IL., Coleman-Cowger VH; The Emmes Company LLC, Rockville, MD., DiFronzo NL; National Heart Lung and Blood Institute, Bethesda, MD., Esrick EB; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA., Field JJ; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI., Fitzhugh CD; Cellular and Molecular Therapeutics Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD., Kanter J; University of Alabama Birmingham, Birmingham, AL., Kapoor N; Children's Hospital of Los Angeles, Los Angeles, CA., Kohn DB; David Geffen School of Medicine, University of California, Los Angeles, CA., Krishnamurti L; David Geffen School of Medicine, University of California, Los Angeles, CA., London WB; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA., Pulsipher MA; Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT., Talib S; California Institute for Regenerative Medicine, San Francisco, CA., Thompson AA; Children's Hospital of Philadelphia, Philadelphia, PA., Waller EK; Emory University, Atlanta, GA., Wun T; University of California Davis School of Medicine, Davis, CA., Horowitz MM; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI. |
المصدر: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2023 Apr 20; Vol. 41 (12), pp. 2227-2237. Date of Electronic Publication: 2023 Jan 09. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural |
اللغة: | English |
بيانات الدورية: | Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 8309333 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-7755 (Electronic) Linking ISSN: 0732183X NLM ISO Abbreviation: J Clin Oncol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2003- : Alexandria, VA : American Society of Clinical Oncology Original Publication: New York, N.Y. : Grune & Stratton, c1983- |
مواضيع طبية MeSH: | Hematopoietic Stem Cell Transplantation*/adverse effects , Graft vs Host Disease*/etiology , Leukemia, Myeloid, Acute* , Anemia, Sickle Cell*/etiology , Neoplasms, Second Primary*/epidemiology , Neoplasms, Second Primary*/etiology, Humans ; Cyclophosphamide ; Transplantation Conditioning/adverse effects ; Whole-Body Irradiation |
مستخلص: | Purpose: To report the incidence and risk factors for secondary neoplasm after transplantation for sickle cell disease. Methods: Included are 1,096 transplants for sickle cell disease between 1991 and 2016. There were 22 secondary neoplasms. Types included leukemia/myelodysplastic syndrome (MDS; n = 15) and solid tumor (n = 7). Fine-Gray regression models examined for risk factors for leukemia/MDS and any secondary neoplasm. Results: The 10-year incidence of leukemia/MDS was 1.7% (95% CI, 0.90 to 2.9) and of any secondary neoplasm was 2.4% (95% CI, 1.4 to 3.8). After adjusting for other risk factors, risks for leukemia/MDS (hazard ratio, 22.69; 95% CI, 4.34 to 118.66; P = .0002) or any secondary neoplasm (hazard ratio, 7.78; 95% CI, 2.20 to 27.53; P = .0015) were higher with low-intensity (nonmyeloablative) regimens compared with more intense regimens. All low-intensity regimens included total-body irradiation (TBI 300 or 400 cGy with alemtuzumab, TBI 300 or 400 cGy with cyclophosphamide, TBI 200, 300, or 400 cGy with cyclophosphamide and fludarabine, or TBI 200 cGy with fludarabine). None of the patients receiving myeloablative and only 23% of those receiving reduced-intensity regimens received TBI. Conclusion: Low-intensity regimens rely on tolerance induction and establishment of mixed-donor chimerism. Persistence of host cells exposed to low-dose radiation triggering myeloid malignancy is one plausible etiology. Pre-existing myeloid mutations and prior inflammation may also contribute but could not be studied using our data source. Choosing conditioning regimens likely to result in full-donor chimerism may in part mitigate the higher risk for leukemia/MDS. |
التعليقات: | Comment in: J Clin Oncol. 2023 Jun 10;41(17):3272-3273. (PMID: 37043702) |
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معلومات مُعتمدة: | OT3 HL147741 United States HL NHLBI NIH HHS; R01 AI145231 United States AI NIAID NIH HHS; U24 CA076518 United States CA NCI NIH HHS |
المشرفين على المادة: | 8N3DW7272P (Cyclophosphamide) |
تواريخ الأحداث: | Date Created: 20230109 Date Completed: 20230419 Latest Revision: 20240421 |
رمز التحديث: | 20240421 |
مُعرف محوري في PubMed: | PMC10448940 |
DOI: | 10.1200/JCO.22.01203 |
PMID: | 36623245 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1527-7755 |
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DOI: | 10.1200/JCO.22.01203 |