Second Primary Malignancy after Hematopoietic Stem Cell Transplantation: A Single Institute Experience

Abstract

Abstract Background: Hematopoietic stem cell transplantation (HCT) is a curative treatment for various hematologic malignancies and some benign hematologic diseases. However, in addition to chronic graft-versus-host disease, second primary malignancy is also a long-term adverse effect. Materials and Methods: We retrospectively collected long-term follow-up data of 380 patients who had undergone transplantation (autologous in 184 with 126 long-term survivors and allogeneic in 196 patients with 100 long-term survivors) between 2001 and 2021 and analyzed the incidence and types of second primary malignancy. Results: Twelve patients had second primary malignancy, including five with head-and-neck squamous cell carcinoma (SCC), three with myelodysplastic syndrome/acute myeloid leukemia (MDS/AML), one with acute lymphoblastic leukemia (ALL), one with esophageal SCC, one with breast cancer, and one with papillary thyroid cancer. Of eight patients who underwent allogeneic hematopoietic stem cell transplants, five had head and neck, one had esophageal, one had breast, and one had papillary thyroid cancer. Of four patients who underwent autologous transplants, three had MDS/AML, and one had ALL. The cumulative incidence of second malignancy was 6% at 10 years and 16% at 19 years, and the postautologous and postallogeneic transplant rates were 5% versus 7% at 10 years and 15% versus 17% at 19 years. Conclusion: The occurrence of a second malignancy after HCT is a crucial issue of concern, and an early diagnosis is essential for posttransplant patients.