Skin Cancer Awareness Recommended For HCT Recipients

By Lynda Williams, Senior medwireNews Reporter

Patients who undergo haematopoietic cell transplantation (HCT) should be educated on the risk of skin cancer and the need for regular self-examination, US researchers say.

Their systematic review of the risk of cutaneous malignant neoplasms after HCT included data from 14 cohort studies, one case–control study, one randomised clinical trial, and two studies combining case–control and cohort methodology.

Cutaneous malignant neoplasms accounted for between 0% and 58.5% of second malignancies reported in patients, with squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and melanoma the most commonly reported types.

The 20-year cumulative incidence was 6.5% for BCC, 1.1% for any form of SCC and 3.4% for cutaneous SCC. And HCT recipients were between3.5 and 8.3 times more likely to develop melanoma than age- and gender-matched controls in the population.

Half of the 18 melanomas reported in one study occurred in the first 4 years after HCT. And the median time from HCT to skin cancer diagnosis was between 7.3 and 9.4 years for BCC patients and 2.1 and 7.0 for those with SCC.

Analysis suggested that BCC was associated with a primary diagnosis of leukaemia, lymphoma or malignant marrow disease, light skin colour, younger age at time of HCT, total body irradiation (TBI) and chronic graft versus host disease (GVHD).

Meanwhile, patients who developed SCC were likely to have had a primary diagnosis of leukaemia or severe aplastic anaemia, younger age at HCT, chronic GVHD, and receipt of immunosuppressive drugs, including azathioprine, for more than 2 years.

Melanoma was linked to female gender, TBI and T-cell depletion, add Jennifer DePry, from University Hospitals Case Medical Center in Cleveland, Ohio, and co-authors.

“Although the risk is less than that for [solid organ transplant recipients], patients need to be educated on the importance of self-examination and pursue regular follow-up with a dermatologist”, the researchers emphasise in JAMA Dermatology.

“Dermatologists should be part of the multidisciplinary team observing these patients and be aware of the risk factors that may increase this population’s risk of cutaneous malignant neoplasms.”

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