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April 14, 2020
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Host-associated risk factors identified in development of keratinocyte carcinoma

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Jeffrey F. Scott

A predominance of host-associated risk factors compared with transplant-associated risk factors has been identified in association with the development of keratinocyte carcinoma after allogeneic hematopoietic cell transplant, according to a study published in JAMA Dermatology.

“Recipients of allogeneic hematopoietic cell transplant (alloHCT) are at an increased risk of skin cancer, and these skin cancers can lead to significant morbidity particularly as patients are now surviving longer after transplant,” Jeffrey F. Scott, MD, of the department of dermatology at Johns Hopkins University School of Medicine, told Healio. “Since host factors are responsible for the majority of skin cancer risk in the general population, we hypothesized that these factors also significantly contribute to skin cancer risk in alloHCT recipients.”

In this retrospective cohort study, alloHCT recipients from the Mayo Clinic and University Hospitals Cleveland Medical Center between Jan. 1, 2000, and Dec. 31, 2014, were analyzed to determine the statistical significance of individual risk factors. Transplant-associated risk factors were defined as those related to alloHCT, while host-related risk factors were defined as those related to the patient.

Among 872 recipients identified in the Mayo Clinic cohort, 10.9% developed keratinocyte carcinoma after alloHCT. Of the 147 recipients identified at University Hospitals Cleveland Medical Center, 12.2% developed keratinocyte carcinoma after alloHCT.

A predominance of host-associated risk factors compared with transplant-associated risk factors has been identified in association with the development of keratinocyte carcinoma after allogeneic hematopoietic cell transplant.

Risk factors that were independently associated with keratinocyte carcinoma included age (HR per 10 years = 1.72; 95% CI, 1.21-2.42), chronic lymphocytic leukemia (HR = 2.47; 95% CI, 1.20-5.09), clinically photodamaged skin (HR = 3.47; 95% CI, 1.87-6.41) and history of cutaneous squamous cell carcinoma (HR = 2.60; 95% CI, 1.41-5.91).

“These findings suggest that host-associated risk factors contribute significantly to skin cancer risk after alloHCT,” Scott said. “We recommend that clinicians caring for alloHCT recipients or patients eligible for alloHCT should establish baseline keratinocyte carcinoma risk in their patients. The goal is to identify patients at highest risk for keratinocyte carcinoma who may perhaps benefit from more frequent skin cancer screening and education on sun-protective behaviors.”– by Kate Burba

 

Disclosures: Scott reports he receives grants from the American Society for Dermatologic Surgery. Please see the study for all other authors’ relevant financial disclosures.