Solid cancers after bone marrow transplantation.
Background The late effects of bone marrow transplantation, including cancer, need to be determined in a large population at risk.
Methods We studied 19,229 patients who received allogeneic transplants (97.2 percent) or syngeneic transplants (2.8 percent) between 1964 and 1992 at 235 centers to evaluate the risk of the development of a new solid cancer.
Risk factors relating to the patient, the transplant, and the course after transplantation were evaluated.
Results The transplant recipients were at significantly higher risk of new solid cancers than the general population (observed cases, 80 ; ratio of observed to expected cases, 2.7 ; P<0.001).
The risk was 8.3 times as high as expected among those who survived 10 or more years after transplantation.
The cumulative incidence rate was 2.2 percent (95 percent confidence interval, 1.5 to 3.0 percent) at 10 years and 6.7 percent (95 percent confidence interval, 3.7 to 9.6 percent) at 15 years.
The risk was significantly elevated (P<0.05) for malignant melanoma (ratio of observed to expected cases, 5.0) and cancers of the buccal cavity (11.1), liver (7.5), brain or other parts of the central nervous system (7.6), thyroid (6.6), bone (13.4), and connective tissue (8.0).
The risk was higher for recipients who were younger at the time of transplantation than for those who were older (P for trend,<0.001).
In multivariate analyses, higher doses of total-body irradiation were associated with a higher risk of solid cancers. (...)
Mots-clés Pascal : Transplantation, Moelle osseuse, Facteur risque, Tumeur maligne, Solide, Etude cohorte, Caractéristique, Etiopathogénie, Analyse statistique, Surveillance, Long terme, Critère âge, Evaluation, Homme, Prévention, Chirurgie, Système nerveux pathologie, Immunopathologie, Système ostéoarticulaire pathologie, Génie biomédical
Mots-clés Pascal anglais : Transplantation, Bone marrow, Risk factor, Malignant tumor, Solid, Cohort study, Characteristic, Etiopathogenesis, Statistical analysis, Surveillance, Long term, Age criterion, Evaluation, Human, Prevention, Surgery, Nervous system diseases, Immunopathology, Diseases of the osteoarticular system, Biomedical engineering
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0230579
Code Inist : 002B25J02. Création : 11/06/1997.