Survival with second cancer after stem cell transplant tied to cancer type

Last Updated: 2018-12-05

By Reuters Staff

NEW YORK (Reuters Health) - The outcome of second solid cancers following hematopoietic stem cell transplantation (HSCT) is strongly related to cancer type, with pancreatic and lung cancer being among those with the poorest outcome, according to European researchers.

Cancer is the main cause of death among patients who survive five years or more after allogeneic HSCT, Dr. Andr Tichelli of University Hospital Basel, in Switzerland, and colleagues observe in JAMA Oncology, online November 21.

To gain further information on risks and susceptibility, the team examined data on more than 220,000 patients who underwent a transplant between 2000 and 2014.

After a median follow-up of 3.65 years, 1.8% subsequently received a diagnosis of one of 18 different types of second solid cancers. Among the most frequent were lung, breast and prostate cancer.

The five-year age-standardized overall survival was 47%. This was poorest for pancreas, lung, hepatobiliary, esophageal, brain and gastric cancers, with a median survival ranging only as high as a year.

For endometrial, colorectal, sarcomas, ovarian, bladder, oropharyngeal and kidney cancers, the median survival was from two to 10 years. For melanoma, breast, prostate, cervix and thyroid cancers, the median survival was 10 years or more.

For each type of cancer, the team calculated the death rate attributable to the second cancer compared with the expected death rate for the corresponding cancer in the general population. This was higher for melanoma, prostate, breast, kidney, bladder, colorectal and endometrial cancers, but not for the others.

Given the higher risk of certain cancers, the researchers call for futher studies "to identify whether patients with these cancers should be treated differently from the general population." This, they add, "will require close cooperation between oncologists and hematologists."

Dr. Tichelli did not respond to requests for comments.

SOURCE: https://bit.ly/2KXdh9O

JAMA Oncol 2018.