Allogeneic HSCT Recipients Have Increased Risk for Skin Cancer

Allogeneic hematopoietic stem-cell transplant (HSCT) recipients have an increased risk for developing basal cell carcinoma, squamous cell carcinoma, and malignant melanoma, a new study published online ahead of print in JAMA Dermatology has shown.¹

Although the risk of nonmelanoma skin cancer is well recognized in patients who have undergone solid-organ transplant, there are limited data on the risk of cancer in HSCT recipients.

Therefore, researchers sought to evaluate the risk of cutaneous cancer in HSCT recipients compared with that of renal transplant recipients and those who have not undergone any transplant.

For the study, researchers analyzed data from 3,302 HSCT recipients (1,007 allogeneic, 2,295 autologous), 4,789 renal transplant recipients, and 10 matched nontransplanted individuals for each of the groups from the general population.

Results showed that allogeneic HSCT recipients had an increased risk of basal cell carcinoma (HR=3.1; 95% CI: 1.0 – 5.2), squamous cell carcinoma (HR=18.3; 95% CI: 4.1 – 81.8), and malignant melanoma (HR=5.5; 95% CI: 1.7 – 17.7) compared with the general population.

Researchers found that allogeneic HSCT recipients also had a 3-fold higher risk of malignant melanoma compared with renal transplant recipients, while the risk of basal cell carcinoma was only increased in allogeneic HSCT recipients conditioned with total-body irradiation (HR=3.9; 95% CI: 2.6 – 6.8).

On the other hand, the risk of basal cell carcinoma was similar among allogeneic HSCT and renal transplant recipients and the risk of squamous cell carcomina was highest among renal transplant recipients.

The study demonstrated no elevated risk for skin cancer among autologous HSCT recipients.

“Our findings indicate the relevance of dermatologic follow-up in HSCT recipients,” the authors concluded. “Furthermore, studies examining prognosis of skin cancer in HSCT recipients are needed.”

Reference

1. Omland SH, Gniadecki R, Hædersdal M, et al. Skin cancer risk in hematopoietic stem-cell transplant recipients compared with background population and renal transplant recipients: a population-based cohort study [published online ahead of print October 10, 2015]. JAMA Dermatol. doi: 10.1001.jamadermatol.2015.3902.