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Hematopoietic cell transplant patients at higher risk of cutaneous malignant neoplasms

Patients who underwent hematopoietic cell transplantation had an increased risk of cutaneous malignant neoplasms, according to recently published study results.

Researchers conducted a systematic review of Medline (PubMed) and Cochrane databases from January 1995 to December 2013, including search terms “stem cell transplant” and/or “bone marrow transplant” combined with “skin malignancy, squamous cell carcinoma [SCC], basal cell carcinoma [BCC], melanoma, Merkel cell carcinoma, keratoacanthoma” and “Kaposi’s sarcoma.” Of 2,377 studies, 18 articles met inclusion criteria of retrospective and prospective reviews of cohorts including at least 100 patients who underwent hematopoietic cell transplantation (HCT), with skin cancer analyzed as primary outcome. The studies included 14 cohort, one case-control, two combined nested case-control and cohort studies and one randomized clinical trial.

The articles were reviewed for information regarding the entire cohort, data from cohorts who developed cutaneous malignant neoplasms, as well as cutaneous malignant neoplasm risk factors. The Strength of Recommendation Taxonomy scale was used to measure the level of evidence of each study.

In 14 of 18 studies, skin cancers were observed among the HCT recipients. The most common cutaneous malignant neoplasms reported were SCC, BCC and melanoma.  Cutaneous malignant neoplasms were possibly associated with primary disease, graft-vs.-host disease, prolonged immunosuppression, radiation exposure, light skin color, sex, age at transplantation and T-cell depletion.

“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,” the researchers concluded. — by Bruce Thiel

Disclosure: DePry reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.