Although patients who have received a bone marrow transplant are at greater risk of skin neoplasms, the prevalence has until now remained poorly quantified, particularly for basal cell carcinomas and poorly understood risk factors. An American study provides new data, with a cohort of nearly 4,000 patients having survived at least two years after a bone marrow transplant followed for a median of 9.5 years.
The researchers establish the cumulative incidence over thirty years of malignant skin neoplasms at 27.4%, or 605 people having developed 778 cancers. More specifically, 321 basal cell carcinomas, 231 squamous cell carcinomas, 78 melanomas and 148 cancers of unknown type were diagnosed. The results are published in the journal Jama Dermatology.
Compared to the general population based on sex and age, the risk of developing melanoma after a bone marrow transplant is multiplied by 5. The patients were also compared to members of their siblings: they have a risk of 2 to 15 times higher for basal cell carcinomas, 2 to 20 times for squamous cell carcinomas.
Different risks depending on the treatments associated with the transplant
Other factors modulate the risk in these patients: age greater than 50 years at the time of transplantation, male gender, Caucasian origin, a history of chronic graft-versus-host disease after allogeneic transplantation and post-allogeneic immunosuppression. -transplantation increases the likelihood of skin cancer.
Unpublished insights from the study: the risk of skin neoplasms is increased in the event of pre-transplant exposure to treatment with monoclonal antibodies, particularly rituximab, regardless of age, and the risk of basal cell carcinoma by total irradiation in patients transplanted under 50 years of age. Among patients transplanted before age 18, women were more at risk for this cancer.
These results highlight the need for post-bone marrow transplant dermatological monitoring, personalized according to the risk factors of different types of skin neoplasm.
Health
