Risk Factors for Subsequent Central Nervous System Tumors in Pediatric Allogeneic Hematopoietic Cell Transplant: A Study from the Center for International Blood and Marrow Transplant Research (CIBMTR)
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Risk Factors for Subsequent Central Nervous System Tumors in Pediatric Allogeneic Hematopoietic Cell Transplant : A Study from the Center for International Blood and Marrow Transplant Research (CIBMTR). / Gabriel, Melissa; Shaw, Bronwen E; Brazauskas, Ruta; Chen, Min; Margolis, David A; Sengelov, Henrik; Dahlberg, Ann; Ahmed, Ibrahim A; Delgado, David; Lazarus, Hillard M; Gibson, Brenda; Myers, Kasiani C; Kamble, Rammurti T; Abdel-Mageed, Aly; Li, Chi-Kong; Flowers, Mary E D; Battiwalla, Minoo; Savani, Bipin N; Majhail, Navneet; Shaw, Peter J.
I: Biology of Blood and Marrow Transplantation, Bind 23, Nr. 8, 2017, s. 1320-1326.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Risk Factors for Subsequent Central Nervous System Tumors in Pediatric Allogeneic Hematopoietic Cell Transplant
T2 - A Study from the Center for International Blood and Marrow Transplant Research (CIBMTR)
AU - Gabriel, Melissa
AU - Shaw, Bronwen E
AU - Brazauskas, Ruta
AU - Chen, Min
AU - Margolis, David A
AU - Sengelov, Henrik
AU - Dahlberg, Ann
AU - Ahmed, Ibrahim A
AU - Delgado, David
AU - Lazarus, Hillard M
AU - Gibson, Brenda
AU - Myers, Kasiani C
AU - Kamble, Rammurti T
AU - Abdel-Mageed, Aly
AU - Li, Chi-Kong
AU - Flowers, Mary E D
AU - Battiwalla, Minoo
AU - Savani, Bipin N
AU - Majhail, Navneet
AU - Shaw, Peter J
N1 - Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Survivors of hematopoietic cell transplantation (HCT) are at risk of subsequent solid tumors, including central nervous system (CNS) tumors. The risk of CNS tumors after HCT in pediatric HCT recipients is not known. We evaluated the incidence and risk factors for CNS tumors in pediatric recipients of allogeneic HCT reported to the Center for International Blood and Marrow Transplant Research between 1976 and 2008. A case control design was used. There were no CNS tumors in the nonmalignant cohort (n = 4543) or in those undergoing HCT for solid tumors (n = 26). There were 59 CNS tumors in 8720 patients transplanted for hematologic malignancies. In comparison with the general population, pediatric HCT recipients with hematologic malignancies had a 33 times higher than expected rate of CNS tumors (95% confidence interval, 22.98 to 45.77; P < .0001). The cumulative incidence of subsequent CNS tumors was 1.29% (95% confidence interval .87 to 1.87) at 20 years after HCT. Significant risk factors in the entire cohort were having an unrelated donor (HR, 3.35; P = .0002) and CNS disease before HCT for both acute lymphoblastic leukemia (HR, 8.21; P = .0003) and acute myeloid leukemia (HR, 6.21; P = .0174). Analysis of the matched cohort showed having an unrelated donor transplant (HR, 4.79; P = .0037), CNS disease before HCT (HR, 7.67; P = .0064), and radiotherapy exposure before conditioning (HR, 3.7; P = .0234) to be significant risk factors. Chronic graft-versus-host disease was associated with a lower risk (HR, .29; P = .0143). Survivors of HCT for nonmalignant diseases did not show an increased incidence of CNS tumors, whereas survivors of hematologic malignancies have a markedly increased incidence of CNS tumors that warrants lifelong surveillance.
AB - Survivors of hematopoietic cell transplantation (HCT) are at risk of subsequent solid tumors, including central nervous system (CNS) tumors. The risk of CNS tumors after HCT in pediatric HCT recipients is not known. We evaluated the incidence and risk factors for CNS tumors in pediatric recipients of allogeneic HCT reported to the Center for International Blood and Marrow Transplant Research between 1976 and 2008. A case control design was used. There were no CNS tumors in the nonmalignant cohort (n = 4543) or in those undergoing HCT for solid tumors (n = 26). There were 59 CNS tumors in 8720 patients transplanted for hematologic malignancies. In comparison with the general population, pediatric HCT recipients with hematologic malignancies had a 33 times higher than expected rate of CNS tumors (95% confidence interval, 22.98 to 45.77; P < .0001). The cumulative incidence of subsequent CNS tumors was 1.29% (95% confidence interval .87 to 1.87) at 20 years after HCT. Significant risk factors in the entire cohort were having an unrelated donor (HR, 3.35; P = .0002) and CNS disease before HCT for both acute lymphoblastic leukemia (HR, 8.21; P = .0003) and acute myeloid leukemia (HR, 6.21; P = .0174). Analysis of the matched cohort showed having an unrelated donor transplant (HR, 4.79; P = .0037), CNS disease before HCT (HR, 7.67; P = .0064), and radiotherapy exposure before conditioning (HR, 3.7; P = .0234) to be significant risk factors. Chronic graft-versus-host disease was associated with a lower risk (HR, .29; P = .0143). Survivors of HCT for nonmalignant diseases did not show an increased incidence of CNS tumors, whereas survivors of hematologic malignancies have a markedly increased incidence of CNS tumors that warrants lifelong surveillance.
KW - Adolescent
KW - Adult
KW - Allografts
KW - Central Nervous System Neoplasms/mortality
KW - Child
KW - Child, Preschool
KW - Female
KW - Hematologic Neoplasms/mortality
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Incidence
KW - Infant
KW - Leukemia, Myeloid, Acute/mortality
KW - Male
KW - Neoplasms, Second Primary/mortality
KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality
KW - Unrelated Donors
U2 - 10.1016/j.bbmt.2017.04.004
DO - 10.1016/j.bbmt.2017.04.004
M3 - Journal article
C2 - 28411175
VL - 23
SP - 1320
EP - 1326
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 8
ER -
ID: 195045126