title: Nonhematologic malignancies after allogeneic hematopoietic stem cell transplantation: incidence and molecular monitoring.
abstract: Survivors of allogeneic hematopoietic stem cell transplantation (HSCT) are at a life-long increased risk of secondary nonhematologic malignancies. In 615 adult Chinese allogeneic HSCT patients, nine developed nonhematologic malignancies. The 5-year cumulative incidence was 6.1%, 4.5 times the background cancer incidence. Early-onset (within first 6 months) and late-onset (>3 years) subtypes were observed. Secondary cancers included hepatocellular carcinoma, oral and esophageal squamous cell tumors and lung adenocarcinoma in a female nonsmoker. The spectrum reflected local cancer epidemiology, which was different from Western populations. The pathogenesis might be related to acceleration of pre-existing cancers (early-onset type), or prolonged immunosuppression (late-onset type). DNA chimerism studies showed that all tumors were recipient-derived. In the plasma, DNA in all cases was apparently donor-derived, although aberrantly methylated p15 was detectable in a patient with a p15-methylated secondary cancer, implying that minute quantities of tumor (and therefore recipient) derived DNA might be present.
authors.affiliation: Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: W-Y
authors.initials: WY
authors.lastname: Au
authors.forename: E C
authors.initials: EC
authors.lastname: Chan
authors.forename: A
authors.initials: A
authors.lastname: Pang
authors.forename: A K W
authors.initials: AK
authors.lastname: Lie
authors.forename: R
authors.initials: R
authors.lastname: Liang
authors.forename: A P W
authors.initials: AP
authors.lastname: Yuen
authors.forename: T W H
authors.initials: TW
authors.lastname: Shek
authors.forename: Y-L
authors.initials: YL
authors.lastname: Kwong
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000209:etiology / Q000235:genetics*; D018797:Cell Cycle Proteins / Q000235:genetics*; D050762:Cyclin-Dependent Kinase Inhibitor p15; D019175:DNA Methylation; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000235:genetics*; D012189:Retrospective Studies; D018183:Transplantation Chimera / Q000235:genetics; D019172:Transplantation Conditioning / Q000009:adverse effects; D025521:Tumor Suppressor Proteins / Q000235:genetics*
chemical_list: C493966:CDKN2B protein, human; D018797:Cell Cycle Proteins; D050762:Cyclin-Dependent Kinase Inhibitor p15; D004273:DNA, Neoplasm; D025521:Tumor Suppressor Proteins