Table 3.
Risk for melanoma after allogeneic HCT according to post-transplant characteristics, adjusted for ambient UVR only*
| Post-transplant characteristics | Cases n=140 |
Controls n=557 |
OR* | 95%CI | P | Overall P** | ||
|---|---|---|---|---|---|---|---|---|
| n | % | n | % | |||||
| Acute GVHD grade | ||||||||
| No acute GVHD | 45 | 32.1 | 224 | 40.2 | ref | 0.20 | ||
| Acute GVHD grade 1 | 28 | 20.0 | 115 | 20.6 | 1.24 | (0.74, 2.09) | 0.42 | |
| Acute GVHD grade 2+ | 62 | 44.3 | 204 | 36.6 | 1.56 | (1.00, 2.43) | 0.05 | |
| Missing | 5 | 3.6 | 14 | 2.5 | 2.03 | (0.64, 6.42) | 0.23 | |
| Acute GVHD skin involvement† | ||||||||
| No acute GVHD | 45 | 32.1 | 224 | 40.2 | ref | 0.09 | ||
| No/unknown skin involvement | 9 | 6.4 | 29 | 5.2 | 1.45 | (0.62, 3.38) | 0.39 | |
| Stage 0/1 | 25 | 17.9 | 120 | 21.5 | 1.08 | (0.62, 1.87) | 0.79 | |
| Stage 2+ | 61 | 43.6 | 184 | 33.0 | 1.69 | (1.08, 2.63) | 0.02 | |
| Steroid treatment for acute GVHD | ||||||||
| No acute GVHD | 45 | 32.1 | 224 | 40.2 | ref | 0.30 | ||
| Did not receive treatment | 3 | 2.1 | 11 | 2.0 | 1.51 | (0.40, 5.74) | 0.55 | |
| Received steroids | 88 | 62.9 | 304 | 54.6 | 1.48 | (0.98, 2.24) | 0.06 | |
| Received treatment other than steroids | 4 | 2.9 | 18 | 3.2 | 1.14 | (0.37, 3.56) | 0.82 | |
| Number of lines of therapy for acute GVHD | ||||||||
| No acute GVHD | 45 | 32.1 | 224 | 40.2 | ref | 0.29 | ||
| No therapy | 3 | 2.1 | 12 | 2.2 | 1.39 | (0.37, 5.21) | 0.63 | |
| 1 line of therapy | 11 | 7.9 | 45 | 8.1 | 1.23 | (0.58, 2.62) | 0.59 | |
| >1 line of therapy | 81 | 57.9 | 276 | 49.6 | 1.50 | (0.99, 2.28) | 0.06 | |
| Chronic GVHD | ||||||||
| No chronic GVHD | 48 | 34.3 | 202 | 36.3 | ref | 0.62 | ||
| Limited/extensive | 92 | 65.7 | 355 | 63.7 | 1.11 | (0.73, 1.69) | 0.62 | |
| Chronic GVHD skin involvement | ||||||||
| No chronic GVHD | 48 | 34.3 | 202 | 36.3 | ref | 0.13 | ||
| Missing skin involvement | 2 | 1.4 | 6 | 1.1 | 1.37 | (0.27, 6.96) | 0.70 | |
| No skin involvement | 24 | 17.1 | 57 | 10.2 | 1.86 | (1.03, 3.36) | 0.04 | |
| Yes skin involvement | 66 | 47.1 | 292 | 52.4 | 0.96 | (0.62, 1.50) | 0.86 | |
| Steroid treatment for chronic GVHD | ||||||||
| No chronic GVHD | 48 | 34.3 | 202 | 36.3 | ref | 0.46 | ||
| Did not receive treatment | 5 | 3.6 | 11 | 2.0 | 1.94 | (0.64, 5.85) | 0.24 | |
| Received steroids | 83 | 59.3 | 317 | 56.9 | 1.14 | (0.74, 1.75) | 0.56 | |
| Received treatment other than steroids | 4 | 2.9 | 27 | 4.8 | 0.62 | (0.21, 1.87) | 0.40 | |
| Number of lines of therapy for chronic GVHD | ||||||||
| No chronic GVHD | 48 | 34.3 | 202 | 36.3 | ref | 0.51 | ||
| No therapy | 5 | 3.6 | 12 | 2.2 | 1.79 | (0.60, 5.29) | 0.30 | |
| 1 line of therapy | 13 | 9.3 | 38 | 6.8 | 1.55 | (0.76, 3.19) | 0.23 | |
| >1 line of therapy | 74 | 52.9 | 305 | 54.8 | 1.03 | (0.66, 1.59) | 0.91 | |
| Relapse | ||||||||
| No§ | 121 | 86.4 | 459 | 82.4 | ref | 0.22 | ||
| Yes | 19 | 13.6 | 98 | 17.6 | 0.71 | (0.41, 1.24) | 0.23 | |
| Infusion | ||||||||
| No | 126 | 90.0 | 500 | 89.8 | ref | 0.87 | ||
| Yes | 14 | 10.0 | 57 | 10.2 | 0.95 | (0.51, 1.78) | 0.88 | |
| Keratinocytic carcinoma | ||||||||
| No | 122 | 87.1 | 524 | 94.1 | ref | 0.01 | ||
| Yes | 18 | 12.9 | 33 | 5.9 | 2.54 | (1.28, 5.06) | 0.01 | |
| Other neoplasm (non-skin)¶ | ||||||||
| No | 134 | 95.7 | 538 | 96.6 | ref | 0.53 | ||
| Yes | 6 | 4.3 | 19 | 3.4 | 1.37 | (0.52, 3.61) | 0.52 | |
Abbreviations: CI - confidence interval; GVHD - graft-versus-host disease; HCT - hematopoietic cell transplantation; OR - odds ratio; ref - referent; UVR - ultraviolet radiation.
Models were adjusted for ambient UVR in tertiles (see Table 1 footnote). Tertile 1: referent; Tertile 2: OR, 1.04; 95%CI, 0.64–1.67; Tertile 3: OR, 1.53; 95%CI, 0.97–2.34.
The likelihood ratio statistic was calculated comparing model fit for a model with ambient UVR alone to a model also including the variable of interest.
Acute GVHD skin involvement: stage 0/1 includes no rash or maculopapular rash <25% of body surface, stage 2+ includes maculopapular rash ≥25% of body surface or generalized erythroderma.
No relapse includes 1 control with missing data.
Non-skin neoplasm diagnoses included breast cancer (2 controls), genitourinary malignancy (3 cases, 4 controls), gastrointestinal malignancy (1 case, 1 control), thyroid cancer (1 case, 1 control), spindle cell carcinoma (1 control), myelodysplastic syndrome (1 control), lymphoma (1 case, 1 control), T-cell large granular lymphocytic leukemia (1 control), and unknown (7 controls).