Squamous cell carcinomas after allogeneic bone marrow transplantation for aplastic anemia: further evidence of a multistep process.
BACKGROUND
Secondary solid tumors are rare events occurring in patients who underwent allogeneic marrow transplantation for aplastic anemia and Fanconi's anemia. Human herpes virus 8 (HHV8), Epstein-Barr virus (EBV), and human papillomaviruses (HPV) sequences have been found in squamous cell carcinoma (SCC) occurring in organ transplant recipients. The tumor suppressor gene p53 has been strongly linked to the occurrence of SCC in the nonimmunocompromised population.


METHODS
In eight patients with SCC, we searched for HHV8, EBV, varicella zoster virus, adenovirus, and HPV sequences from DNA extracted from selected areas of SCC. We also looked for p53 expression in those specimens as well as the presence of anti-p53 antibodies in the serum of these patients at the onset of SCC.


RESULTS
In one patient, we found the presence of both HHV8 and EBV sequences, and in another patient we found HPV16 sequences. All five tumors that could be studied disclosed evidence of p53 accumulation, but none of the eight patients had anti-p53 antibodies in the sera.


CONCLUSIONS
SCC developing in marrow transplant recipients seems to occur via a multistep process. Genetic predisposition may be present, as in patients with Fanconi's anemia. Transplantation-related factors, such as irradiation and chronic graft-versus-host disease, also have a role. In this article, we add two more potent risk factors: p53 alteration(s) and in some cases the presence of oncogenic viruses.
Socié
G
G
Service d'Hématologie-Greffe de Moelle, Unité de Recherche sur la Biologie des Cellules Souches, Hôpital Saint-Louis, Paris, France. gsocie@chu.stlouis.fr
Scieux
C
C
Gluckman
E
E
Soussi
T
T
Clavel
C
C
Saulnier
P
P
Birembault
P
P
Bosq
J
J
Morinet
F
F
Janin
A
A
D000741:Anemia, Aplastic / Q000628:therapy*; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000209:etiology* / Q000821:virology; D005199:Fanconi Anemia / Q000628:therapy; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000302:isolation & purification; D016159:Tumor Suppressor Protein p53 / Q000276:immunology / Q000378:metabolism
D016159:Tumor Suppressor Protein p53