Allograft treatment increases risk of second tumour.

摘要

Patients undergoing an ailograft for haematological cancers, especially those 40 years of age or older, are at increased risk of developing a second cancer compared with the general population. The risk is even higher for patients whose donor was female, according to a large retrospective study. "The cumulative incidence of developing a second solid cancer [eg, skin or lung] 10 years after an allogeneic transplant was 3.1% [95% CI 2-5] and when compared with the general population of British Columbia, adjusted for age and sex, the risk ratio was 1.85 [1.04-3.06]", says lead author, Donna Forrest (Gordon and Leslie Diamond Health Center, Vancouver, BC, Canada). The increased incidence of cancers in patients undergoing allogeneic haematopoietic stem-cell transplantation is, according to Forrest, likely to be multifactorial. Treatment of the initial cancer with chemotherapy and radiotherapy before transplantation as well as giving these treatments at the time of transplantation is known to be carcinogenic. Furthermore, these patients might be inherently at increased risk of developing a second cancer for genetic or environmental reasons, or from impaired immune surveillance.