title: Risk of melanocytic nevi and nonmelanoma skin cancer in children after allogeneic hematopoietic stem cell transplantation.
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.
authors.affiliation: Department of Medicine, Dermatology Program, Boston Children's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.|Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Song
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.|Department of Medicine, Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA.
authors.forename: W B
authors.initials: WB
authors.lastname: London
authors.affiliation: Department of Medicine, Dermatology Program, Boston Children's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.|Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Hawryluk
authors.affiliation: Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Guo
authors.affiliation: Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Sridharan
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Fisher
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.|Department of Medicine, Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Lehmann
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.|Department of Medicine, Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Duncan
authors.affiliation: Department of Medicine, Dermatology Program, Boston Children's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.|Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology; D009508:Nevus, Pigmented / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology