Secondary solid cancer screening following hematopoietic cell transplantation

Area of Science:

• Hematology
• Oncology
• Transplantation Medicine

Background:

• Hematopoietic stem cell transplant (HCT) recipients have a significantly increased risk of developing secondary solid cancers.
• This risk persists long-term after transplantation, without plateauing over time.

Purpose of the Study:

• To establish consensus-based recommendations for cancer screening in HCT recipients.
• To facilitate the implementation of appropriate cancer screening protocols for this patient population.

Main Methods:

• A working group reviewed existing cancer screening guidelines for the general population.
• Incidence and risk factors for secondary cancers post-HCT were analyzed.
• A consensus approach was used to develop specific recommendations.

Main Results:

• Common secondary cancer sites include the oral cavity, skin, breast, and thyroid.
• Increased cancer risks post-HCT compared to the general population were observed for skin, thyroid, oral cavity, esophagus, liver, nervous system, bone, and connective tissues.
• Myeloablative total body irradiation (TBI), young age at HCT, chronic graft-versus-host disease (GVHD), and prolonged immunosuppression (>24 months) are key risk factors.

Conclusions:

• HCT recipients require annual counseling regarding secondary cancer risks and recommended screenings.
• Guidelines are proposed to aid clinicians in providing screening and preventive care for secondary cancers in HCT survivors.