Second malignancies following allogeneic bone marrow transplantation (BMT) for hematologic malignancy (Meeting abstract).

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Second malignancies following allogeneic bone marrow transplantation (BMT) for hematologic malignancy (Meeting abstract).

Proc Annu Meet AM Soc Clin Oncol; 12:A993 1993. Unique Identifier : AIDSLINE ICDB/94695392
Taguchi J; Niland J; Blume K; Forman S; City of Hope Natl. Medical Center, Duarte, CA 91010

Abstract: Allogeneic BMT is a therapy aimed at achieving cure for patients suffering from a variety of fatal hematologic malignancies. Although the most common cause of malignancy after BMT is relapse, some reports indicate that long-term BMT survivors are at risk for developing secondary tumors. Between 1976 and 1990, 513 patients underwent allogeneic marrow transplantation from matched sibling donors, utilizing a total body irradiation-containing regimen. No patients received T-cell depleted marrow and all received post-transplant graft-vs-host disease prophylaxis (methotrexate [MTX]/prednisone [PSE], cyclosporin A [CsA]/PSE, or CsA/MTX/PSE). Nine patients developed a second malignancy unrelated to the original tumor between 2 mo and 15 yr (median 6.5 yr) following allogeneic BMT, all while in complete remission of their original hematologic disease. Two patients developed lymphoma (EBV, HIV), one astrocytoma (history of neurofibromatosis), two squamous cell carcinoma, one osteogenic sarcoma (previous irradiated bone), one hepatoma (hepatitis C), one thyroid carcinoma and one parotid carcinoma, leading to the death of four of the nine patients. Two patients who developed malignancy (hepatoma, lymphoma) did so as a consequence of contaminated blood (hepatitis, HIV). The cumulative product-limit risk of developing second malignancy following allogeneic BMT was 0.2% at 1 yr, 0.6% at 2 yr, 2% at 5 yr and 6% from 10-15 yr. These data suggest that: (1) Patients undergoing allogeneic BMT for hematologic malignancy are at low risk for second malignancy, and (2) some patients who do develop a secondary tumor are at risk based on their underlying condition, prior treatment and blood exposures.

Keywords: *Bone Marrow Transplantation Human Leukemia/*SURGERY Neoplasms, Second Primary/*ETIOLOGY Transplantation, Homologous Whole-Body Irradiation ABSTRACT
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