1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

Risk for Malignancy After Bone Marrow Transplantation

While bone marrow transplantation (BMT) can offer cures rather than remission to some patients with malignancies, the associated chemotherapy, radiation, immunosuppression, and other sequelae place recipients at risk for new malignancies. To assess the magnitude of this risk, researchers retrospectively studied all BMT patients from 45 European centers who survived for at least 5 years.

The 1036 patients were followed for a median of 10.6 years. The risk for developing malignant neoplasms was 4 percent at 10 years and 12 percent at 15 years. Of 53 malignant neoplasms, tumors of the skin (14, including 2 melanomas), uterus (6), thyroid (5), breast (4), and brain (3) were the most common. The overall risk was 5 times greater than that in an age- and sex-matched control population. In a multivariable analysis adjusting for donor age, histocompatibility group, and chronic graft-versus-host disease and its treatment, older patient age and receipt of cyclosporine or thalidomide for graft-versus-host disease were associated with an increased risk for malignancy.

Comment: In the case of bone marrow transplantation, cure has a hefty price in terms of both acute and chronic complications. This study quantifies the risk for subsequent malignancies and suggests that follow-up surveillance for treatable cancers is an important component of preventive care after transplantation.

— R Saitz

Published in Journal Watch General Medicine December 7, 1999

Citation(s):

Kolb HJ et al. Malignant neoplasms in long-term survivors of bone marrow transplantation. Ann Intern Med 1999 Nov 16 131 738-744.

• Original article (Subscription may be required)
• Medline abstract (Free)