Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms
IntroductionSurvival post-hematopoietic stem cell transplantation (HCT) is improving, with an increasing number of survivors. Subsequent neoplasms (SNs) following HCTs are of particular concern.MethodsBetween January 2003 and December 2022, HCT recipients’ records were retrospectively reviewed.Resul...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Oncology |
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| author | Rawad Rihani Shrouq Amer Khalid Halahleh Hasan Hashem Zaid Abdel Rahman Laith Baqain Mayada Abu Shanap Iyad Sultan Amr Qudeimat |
| author_facet | Rawad Rihani Shrouq Amer Khalid Halahleh Hasan Hashem Zaid Abdel Rahman Laith Baqain Mayada Abu Shanap Iyad Sultan Amr Qudeimat |
| author_sort | Rawad Rihani |
| collection | DOAJ |
| description | IntroductionSurvival post-hematopoietic stem cell transplantation (HCT) is improving, with an increasing number of survivors. Subsequent neoplasms (SNs) following HCTs are of particular concern.MethodsBetween January 2003 and December 2022, HCT recipients’ records were retrospectively reviewed.ResultsAt a median follow-up of 108 months (range, 0.13-215), 2659 patients received HCTs. Of those, 1131 (43%) were <18 years old. Allogeneic HCTs were conducted in 1476 (56%) patients. Myeloablative conditioning (MAC) was utilized in 2157 (81%), and 583(22%) received TBI. At a median of 9 years following transplant, forty-three patients developed SNs (1.6%) with a median age at time of HCT of 27.6 years (range, 2.8-64.8). Of those: 32 were males (74%), 20 received full HLA-matched allogeneic HCTs (46.5%), two (4.6%) had unrelated cord blood HCT (UCB), and one (2.3%) received haplo-HCT, whereas autologous HCTs accounted for 46.6% (n=20). Underlying diseases were: ALL(13.9%), AML(11.6%), Hodgkin Lymphoma(13.9%), Non-Hodgkin lymphoma(13.9%), Multiple Myeloma(18.6%), Fanconi Anemia(6.9%), CML(6.9%),Neuroblastoma(2.3%), and thalassemia (2.3%).); cGVHD occurred in (74%), and CMV infection/reactivation in (60.5%). Stem cell source included peripheral blood in (81.4%), BM in (3.9%), and UCB in (4.7%). Conditioning regimens were MAC (81.4%) vs RIC (18.6%). TBI-based regimen was utilized in 14 patients (32.5%). Subsequent hematologic malignancies accounted for 32.5% of SNs. While subsequent solid neoplasms occurred in 65.2%, and PTLD occurred in 2.3%. The probability of 5-year overall survival after a SN was 58.2%.ConclusionsSNs adversely impact the overall survival and quality of life of HCT survivors. In our cohort, the rate of post-HCT SNs was lower than that in the literature; however, longer follow-up of our cohort is needed. |
| format | Article |
| id | doaj-art-6d61d440895c410186728ca892976c3a |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-6d61d440895c410186728ca892976c3a2025-08-20T03:08:32ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.15897551589755Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasmsRawad Rihani0Shrouq Amer1Khalid Halahleh2Hasan Hashem3Zaid Abdel Rahman4Laith Baqain5Mayada Abu Shanap6Iyad Sultan7Amr Qudeimat8Department of Pediatrics, Blood and Marrow Transplantation and Cellular Therapy, King Hussein Cancer Center, Amman, JordanDepartment of Pediatrics, Blood and Marrow Transplantation and Cellular Therapy, King Hussein Cancer Center, Amman, JordanAdult Blood and Marrow Transplantation and Cellular Therapy Program, King Hussein Cancer Center, Amman, JordanDepartment of Pediatrics, Blood and Marrow Transplantation and Cellular Therapy, King Hussein Cancer Center, Amman, JordanAdult Blood and Marrow Transplantation and Cellular Therapy Program, King Hussein Cancer Center, Amman, JordanFaculty of Medicine, University of Jordan, Amman, JordanDepartment of Pediatrics, Blood and Marrow Transplantation and Cellular Therapy, King Hussein Cancer Center, Amman, JordanDepartment of Pediatrics, Blood and Marrow Transplantation and Cellular Therapy, King Hussein Cancer Center, Amman, JordanDepartment of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, TN, United StatesIntroductionSurvival post-hematopoietic stem cell transplantation (HCT) is improving, with an increasing number of survivors. Subsequent neoplasms (SNs) following HCTs are of particular concern.MethodsBetween January 2003 and December 2022, HCT recipients’ records were retrospectively reviewed.ResultsAt a median follow-up of 108 months (range, 0.13-215), 2659 patients received HCTs. Of those, 1131 (43%) were <18 years old. Allogeneic HCTs were conducted in 1476 (56%) patients. Myeloablative conditioning (MAC) was utilized in 2157 (81%), and 583(22%) received TBI. At a median of 9 years following transplant, forty-three patients developed SNs (1.6%) with a median age at time of HCT of 27.6 years (range, 2.8-64.8). Of those: 32 were males (74%), 20 received full HLA-matched allogeneic HCTs (46.5%), two (4.6%) had unrelated cord blood HCT (UCB), and one (2.3%) received haplo-HCT, whereas autologous HCTs accounted for 46.6% (n=20). Underlying diseases were: ALL(13.9%), AML(11.6%), Hodgkin Lymphoma(13.9%), Non-Hodgkin lymphoma(13.9%), Multiple Myeloma(18.6%), Fanconi Anemia(6.9%), CML(6.9%),Neuroblastoma(2.3%), and thalassemia (2.3%).); cGVHD occurred in (74%), and CMV infection/reactivation in (60.5%). Stem cell source included peripheral blood in (81.4%), BM in (3.9%), and UCB in (4.7%). Conditioning regimens were MAC (81.4%) vs RIC (18.6%). TBI-based regimen was utilized in 14 patients (32.5%). Subsequent hematologic malignancies accounted for 32.5% of SNs. While subsequent solid neoplasms occurred in 65.2%, and PTLD occurred in 2.3%. The probability of 5-year overall survival after a SN was 58.2%.ConclusionsSNs adversely impact the overall survival and quality of life of HCT survivors. In our cohort, the rate of post-HCT SNs was lower than that in the literature; however, longer follow-up of our cohort is needed.https://www.frontiersin.org/articles/10.3389/fonc.2025.1589755/fullhematopoietic cell transplantation (HCT)second cancerhematologic malignanciescancer survivorshuman leukocyte antigen (HLA)myeloablative conditioning (MAC) |
| spellingShingle | Rawad Rihani Shrouq Amer Khalid Halahleh Hasan Hashem Zaid Abdel Rahman Laith Baqain Mayada Abu Shanap Iyad Sultan Amr Qudeimat Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms Frontiers in Oncology hematopoietic cell transplantation (HCT) second cancer hematologic malignancies cancer survivors human leukocyte antigen (HLA) myeloablative conditioning (MAC) |
| title | Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms |
| title_full | Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms |
| title_fullStr | Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms |
| title_full_unstemmed | Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms |
| title_short | Exploring the aftermath of hematopoietic cell transplantation: 18-year insights into post-transplant neoplasms |
| title_sort | exploring the aftermath of hematopoietic cell transplantation 18 year insights into post transplant neoplasms |
| topic | hematopoietic cell transplantation (HCT) second cancer hematologic malignancies cancer survivors human leukocyte antigen (HLA) myeloablative conditioning (MAC) |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1589755/full |
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