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Transplant Toxicities

Risk of melanocytic nevi and nonmelanoma skin cancer in children after allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 52, pages 989–997 (2017)Cite this article

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Abstract

There is a known increased risk of skin cancer in the adult population after hematopoietic stem cell transplantation (HSCT). However, late dermatologic effects that children may experience after HSCT have not been well described. The primary objective of this study was to characterize nevi and skin cancers affecting children after allogeneic HSCT. A cross-sectional cohort study of 85 pediatric HSCT recipients and 85 controls matched for age, sex and skin phototype was performed at a single institution. All participants underwent a full skin examination. Median age at study visit was 13.8 years in HSCT patients with median time post-HSCT of 3.6 years. HSCT patients had significantly more nevi than control patients (median (range): 44 (0–150) vs 11 (0–94), P<0.0001). HSCT patients also had significantly more nevi >5 mm in diameter and atypical nevi than controls. Factors associated with increased nevus count included malignant indication for HSCT, pretransplant chemotherapy, TBI exposure and myeloablative conditioning. A total of 16.5% of HSCT patients developed cancerous, precancerous lesions and/or lentigines. Our study suggests that pediatric HSCT recipients have an increased risk of benign and atypical melanocytic proliferations and nonmelanoma skin cancer that can manifest even during childhood.

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Acknowledgements

We thank Corinna Rea, MD, physician in Division of Pediatrics and Adolescent Medicine at Boston Children’s Hospital, and Hasan Khosravi, medical student at Harvard Medical School, for their assistance in patient identification and recruitment. We also thank the Society for Pediatric Dermatology for their generous support for our work. This work was supported by a Pilot Project Grant by the Society for Pediatric Dermatology and by a Career Development Award by the Dermatology Foundation. None of the authors have any relevant financial disclosures or other conflicts of interes.

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Authors and Affiliations

  1. Department of Medicine, Dermatology Program, Boston Children’s Hospital, Boston, MA, USA

    J S Song, E B Hawryluk & J T Huang

  2. Harvard Medical School, Boston, MA, USA

    J S Song, W B London, E B Hawryluk, D E Fisher, L E Lehmann, C N Duncan & J T Huang

  3. Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA

    J S Song, E B Hawryluk & D E Fisher

  4. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    W B London, D Guo, M Sridharan, L E Lehmann, C N Duncan & J T Huang

  5. Department of Medicine, Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA, USA

    W B London, L E Lehmann & C N Duncan

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  1. J S Song
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Song, J., London, W., Hawryluk, E. et al. Risk of melanocytic nevi and nonmelanoma skin cancer in children after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 52, 989–997 (2017). https://doi.org/10.1038/bmt.2017.57

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