Table 5.
Risk factors for second solid cancers, according to age at transplantation and type of solid cancer, among survivors for 1 or more years after HCT
| Variable | All solid cancers |
Non-SCCs |
SCCs |
||||||
|---|---|---|---|---|---|---|---|---|---|
| No. cases | RR | 95% CI | No. cases | RR | 95% CI | No. cases | RR | 95% CI | |
| Age < 30 y at HCT | n = 98 | n = 67 | n = 31 | ||||||
| No radiation | 14 | 3 | 11 | ||||||
| TBI | 78 | 3.34† | 1.51-7.93 | 62 | 8.87† | 2.51-45.25 | 16 | 1.12 | 0.33-3.83 |
| LFI, no TBI | 6 | 3.63† | 1.11-11.42 | 2 | 10.40† | 1.27-85.02 | 4 | 1.80 | 0.43-6.97 |
| Chronic GVHD* | 28 | 1.39 | 0.87-2.16 | 8 | 0.46† | 0.20-0.93 | 20 | 6.34† | 3.04-13.92 |
| Age ≥ 30 y at HCT | n = 67 | n = 43 | n = 24 | ||||||
| No radiation | 17 | 10 | 7 | ||||||
| TBI | 47 | 1.09 | 0.58-2.15 | 31 | 1.08 | 0.49-2.60 | 16 | 1.08 | 0.40-3.40 |
| LFI, no TBI | 3 | 3.11 | 0.53-16.06 | 2 | 2.58 | 0.31-15.74 | 1 | 7.21 | 0.15-164 |
| Chronic GVHD* | 28 | 1.72† | 1.02-2.86 | 13 | 1.01 | 0.49-1.97 | 15 | 4.07† | 1.75-9.96 |
Multivariate Poisson regression models were based 165 solid cancers including 18 invasive SCCs of the skin and 13 nonskin carcinomas in situ; analyses were stratified by registry (FHCRC, CIBMTR), age (< 10, 20-29, 30-39, 40-49, ≥ 50 y), latency (1 to < 5, 5 to < 10, 10 to < 15, ≥ 15 y after HCT), and primary disease (ALL, ANLL, CML, SAA, other). Analyses excluded patients with unknown radiation or unknown radiation dose.
*
Chronic GVHD was moderate or severe grade in CIBMTR patients, or clinically extensive in FHCRC patients.
†
P < .05.