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Inherited and Genetic Disorders

Secondary solid cancer following hematopoietic cell transplantation in patients with thalassemia major

Bone Marrow Transplantation volume 53, pages 39–43 (2018)Cite this article

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Abstract

Hematopoietic cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers (SSCs). The aim of this retrospective study was to compare the incidence of SSC in a monocentric cohort of thalassemia major (TM) patients (n=122) who received HCT versus an hematopoietic cell donor monocentric cohort (n=122) and versus a large multicenter cohort of age- and sex-matched TM patients (n=244) who received conventional therapy. With a median follow-up of 24 years, 8 transplanted patients were diagnosed with SSC at a median of 18 years after HCT and at a median age of 33 years. Three patients died of cancer progression and 5 are living after a follow-up ranging from 10 months to 16 years after SSC diagnosis. The 30-year cumulative incidence of developing SSC was 13.24%. The occurrence of solid cancers in the hematopoietic cell donor cohort was limited to only one case for a significantly lower cumulative incidence (3.23%, P=0.02) and to 3 cases in the cohort of nontransplant patients for a significantly lower cumulative incidence (1.32%, P=0.005). This study shows that the magnitude of increased risk of SST is fourfold to sixfold for patients treated with HCT as compared with hematopoietic cell donors and nontransplant patients.

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Acknowledgements

Author contributions

SS and PDB contributed patients, designed the study, analyzed the data and wrote the manuscript; AP and AM contributed patients, performed statistical study and contributed to the interpretation of the results; AN, PO, GP, LC, AS, RL, MDI, PA and TB contributed patients and critically reviewed the manuscript; LP was responsible for data collection; SS and SA performed statistical study; FP performed HLA typing.

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Authors and Affiliations

  1. Department of Hematology, Bone Marrow Transplant Center, Transfusion Center and Biotechnology, Ospedale Civile, Pescara, Italy

    S Santarone, A Natale, P Olioso, G Papalinetti, M Di Ianni, T Bonfini, P Accorsi, S Angelini & P Di Bartolomeo

  2. Magnetic Resonance Imaging Unit, Fondazione G. Monasterio, CNR-Regione Toscana, Pisa, Italy

    A Pepe, A Meloni & L Pistoia

  3. Unità Operativa Complessa Ematologia con Talassemia, ARNAS Civico ‘Benfratelli-Di Cristina’, Palermo, Italy

    L Cuccia

  4. Unità Operativa Semplice Dipartimentale Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale ‘A. Cardarelli’, Napoli, Italy

    A Spasiano

  5. Unità Operativa Dipartimentale Talassemia, Presidio Ospedaliero Garibaldi-Centro–ARNAS Garibaldi, Catania, Italy

    R Lisi

  6. Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche, Pisa, Italy

    S Salvadori

  7. Centro Regionale Immunoematologia, Ospedale San Salvatore, L’Aquila, Italy

    F Papola

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  1. S Santarone
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  4. A Natale
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  6. P Olioso
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  7. G Papalinetti
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  8. L Cuccia
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  9. A Spasiano
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  10. R Lisi
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  11. M Di Ianni
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  12. T Bonfini
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  13. P Accorsi
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  14. S Salvadori
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  15. F Papola
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  16. S Angelini
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  17. P Di Bartolomeo
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Correspondence to P Di Bartolomeo.

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Santarone, S., Pepe, A., Meloni, A. et al. Secondary solid cancer following hematopoietic cell transplantation in patients with thalassemia major. Bone Marrow Transplant 53, 39–43 (2018). https://doi.org/10.1038/bmt.2017.214

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