Megan M Herr1, Rochelle E Curtis2, Margaret A Tucker2, Heather R Tecca3, Eric A Engels2, Elizabeth K Cahoon2, Minoo Battiwalla4, David Buchbinder5, Mary E Flowers6, Ruta Brazauskas3, Bronwen E Shaw3, Lindsay M Morton7. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; Roswell Park Comprehensive Cancer Center, Buffalo, New York. 2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. 3. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin. 4. Sarah Cannon Blood Cancer Network, Nashville, Tennessee. 5. Department of Hematology and Bone Marrow Transplant, Children's Hospital of Orange County, Orange, California. 6. Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Washington. 7. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland. Electronic address: mortonli@mail.nih.gov.
Abstract
BACKGROUND: Melanoma risk is increased after allogeneic hematopoietic cell transplantation (HCT), but specific risk factors are unknown. OBJECTIVE: Investigate risk factors for melanoma after allogeneic hematopoietic cell transplantation. METHODS: We conducted a nested case-control study of 140 melanoma cases and 557 controls (matched by age at HCT, sex, primary disease, survival time) through the Center for International Blood and Marrow Transplant Research. RESULTS: Melanoma risk was significantly increased among HCT survivors who received total body irradiation-based myeloablative conditioning (multivariable adjusted odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.00-3.15) or reduced-intensity conditioning containing melphalan (OR = 2.60; 95% CI = 1.13-6.02) or fludarabine (OR = 2.72; 95% CI = 1.02-7.30) versus busulfan-based myeloablative regimens; were diagnosed with acute graft-versus-host disease (GVHD) with stage 2+ skin involvement (OR = 1.92; 95% CI = 1.19-3.10), chronic GvHD without skin involvement (OR = 1.91; 95% CI = 1.03-3.57), or keratinocytic carcinoma (OR = 2.37; 95% CI = 1.16-4.83); and resided in areas with higher ambient ultraviolet radiation (ORtertile3 = 1.64; 95% CI = 1.01-2.67). LIMITATIONS: Data on individual-level ultraviolet radiation exposure and clinical data on melanoma characteristics were lacking. Additionally, misclassification of melanoma is possible as not all pathology reports were available for review. CONCLUSION: These results emphasize the importance of adherence to current surveillance guidelines (routine skin examination, photoprotection recommendations), particularly for HCT survivors at highest risk.
BACKGROUND:Melanoma risk is increased after allogeneic hematopoietic cell transplantation (HCT), but specific risk factors are unknown. OBJECTIVE: Investigate risk factors for melanoma after allogeneic hematopoietic cell transplantation. METHODS: We conducted a nested case-control study of 140 melanoma cases and 557 controls (matched by age at HCT, sex, primary disease, survival time) through the Center for International Blood and Marrow Transplant Research. RESULTS:Melanoma risk was significantly increased among HCT survivors who received total body irradiation-based myeloablative conditioning (multivariable adjusted odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.00-3.15) or reduced-intensity conditioning containing melphalan (OR = 2.60; 95% CI = 1.13-6.02) or fludarabine (OR = 2.72; 95% CI = 1.02-7.30) versus busulfan-based myeloablative regimens; were diagnosed with acute graft-versus-host disease (GVHD) with stage 2+ skin involvement (OR = 1.92; 95% CI = 1.19-3.10), chronic GvHD without skin involvement (OR = 1.91; 95% CI = 1.03-3.57), or keratinocytic carcinoma (OR = 2.37; 95% CI = 1.16-4.83); and resided in areas with higher ambient ultraviolet radiation (ORtertile3 = 1.64; 95% CI = 1.01-2.67). LIMITATIONS: Data on individual-level ultraviolet radiation exposure and clinical data on melanoma characteristics were lacking. Additionally, misclassification of melanoma is possible as not all pathology reports were available for review. CONCLUSION: These results emphasize the importance of adherence to current surveillance guidelines (routine skin examination, photoprotection recommendations), particularly for HCT survivors at highest risk.
Authors: D J Wojenski; G T Bartoo; J A Merten; R A Dierkhising; M R Barajas; R A El-Azhary; J W Wilson; M F Plevak; W J Hogan; M R Litzow; M M Patnaik; R C Wolf; S K Hashmi Journal: Transpl Infect Dis Date: 2015-04 Impact factor: 2.228
Authors: Megan M Herr; Sara J Schonfeld; Graça M Dores; Diana R Withrow; Margaret A Tucker; Rochelle E Curtis; Lindsay M Morton Journal: J Natl Cancer Inst Date: 2018-11-01 Impact factor: 13.506
Authors: Arash Delavar; D Michal Freedman; Raquel Velazquez-Kronen; Mark P Little; Cari M Kitahara; Bruce H Alexander; Martha S Linet; Elizabeth K Cahoon Journal: Ophthalmic Epidemiol Date: 2018-08-10 Impact factor: 1.648
Authors: Nandita Khera; Eric J Chow; Wendy M Leisenring; Karen L Syrjala; K Scott Baker; Mary E D Flowers; Paul J Martin; Stephanie J Lee Journal: Biol Blood Marrow Transplant Date: 2010-12-08 Impact factor: 5.742
Authors: R E Curtis; P A Rowlings; H J Deeg; D A Shriner; G Socíe; L B Travis; M M Horowitz; R P Witherspoon; R N Hoover; K A Sobocinski; J F Fraumeni; J D Boice Journal: N Engl J Med Date: 1997-03-27 Impact factor: 91.245