Malignant neoplasms following bone marrow transplantation.

摘要: We undertook an analysis of 2,150 recipients bone marrow transplant (BMT) at the University Minnesota to determine incidence post- BMT malignant neoplasms (MNs). Fifty-one patients developed 53 MNs, compared with 4.3 expected from general population rates (standardized ratio [SIR], 11.6, 95% confidence interval [CI], 8.2–14.5). These included 22 occurrences B-cell lymphoproliferative disorder (BLPD), 17 solid nonhematopoietic tumors, 10 myelodysplastic syndromes (MDS), 1 acute myelogenous leukemia (AML), 2 non-Hodgkin's lymphoma (NHL), and Hodgkin's disease (HD). The estimated actuarial any post-BMT malignancy was 9.9% +/- 2.3% 13 years posttransplant. cumulative probability BLPD plateaued 1.6% 0.3% by 4 factors independently associated increased risk in vitro T-cell depletion (relative (RR) = 11.9, P < .001), HLA mismatch (RR 8.9, use antithymocyte globulin (ATG) for graft versus host (GVHD) prophylaxis 5.9, .001) or preparative regimen 3.1, .03) primary immunodeficiency 2.5, .06). developing 5.6% 2.2% BMT. Malignant melanomas were most common (SIR, 10.3, CI 1.9 25.4). MDS/AML 2.1% 0.8% 9 seen often older receiving autologous peripheral blood stem cells HD NHL. data document that are later malignancy, which may add significant morbidity mortality process. Methods screening identification individuals need be addressed future studies.