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Secondary oral cancer following hematopoietic cell transplantation

Bone Marrow Transplantation volume 56, pages 1038–1046 (2021)Cite this article

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Abstract

The aim of this retrospective study was to determine the incidence and the clinical outcome of secondary oral cancer (SOC) and to assess potential risk factors in a large cohort of patients (n = 908), who received allogeneic hemopoietic cell transplantation (HCT) either for a malignant (n = 733) or nonmalignant hematologic disease (n = 175). The median follow-up of 438 transplant survivors was 17 years. Twelve patients developed SOC at a median of 13.5 years since HCT and at a median age of 47 years. The 35-year cumulative incidence function of SOC development was 3.47%. In univariate analysis, factors associated with increased incidence of SOC were reduced intensity conditioning and chronic graft-versus-host disease (cGvHD). On multivariate analysis, nonmalignant disease and duration of oral cGvHD ≥15 months were independent risk factors for SOC development. Nonmalignant disease recipients had 3.94× higher than expected rate of SOC (95% confidence interval, 1.50–10.39%, p = 0.0055). Recipients whose oral cGvHD persisted for more than ≥15 months had 58.6× higher than expected rate of SOC (95% confidence interval, 13.3–258.1%), p < 0.0001). This study demonstrates that oral cGvHD and a diagnosis of nonmalignant hematologic disease are strong risk factors in the SOC development.

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Fig. 1: Cumulative incidence function of secondary oral cancer.

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Acknowledgements

The authors thank Prof. Saman Warnakulasuriya, Emeritus Professor, King’s College London, for his critical review of the paper and his suggestions.

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Authors and Affiliations

  1. Bone Marrow Transplant Center, Department of Oncology Hematology, Ospedale Civile, Pescara, Italy

    Stella Santarone, Annalisa Natale, Gabriele Papalinetti, Doriana Vaddinelli, Andrea Di Bartolomeo & Paolo Di Bartolomeo

  2. UOC Ematologia e Terapia Cellulare, Ospedale Mazzoni, Ascoli Piceno, Italy

    Stefano Angelini

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  1. Stella Santarone
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Contributions

SS and PDB contributed patients, designed the study, analyzed the data, and wrote the manuscript; AN, GP, DV, and ADB contributed to data acquisition and analyzed the results; SA performed statistical study and contributed to the interpretation of the results. All authors read and critically reviewed the manuscript and approved the final version.

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Correspondence to Stella Santarone.

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Santarone, S., Natale, A., Angelini, S. et al. Secondary oral cancer following hematopoietic cell transplantation. Bone Marrow Transplant 56, 1038–1046 (2021). https://doi.org/10.1038/s41409-020-01147-z

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