Secondary Malignancies After Autologous Stem Cell Transplantations in Patients With Malignant Lymphoma and Multiple Myeloma.

Abstract

Background: Secondary malignancies are potential complications after high-dose therapy and autologous stem cell transplantation (ASCT). Information on the detailed course of such events is scarce, yet may be essential to minimize the impact of these sequelae.

Patients and methods: We regularly monitored 877 patients for up to 31 years after ASCT in our outpatient department.

Results: Four-hundred and five patients with malignant lymphoma and 472 patients with multiple myeloma were analysed with a median follow-up from the initial malignant diagnosis of 7.0 years (0.5-35.5), from ASCT of 4.8 years (range 0.2-31.3). Eighty-nine of these patients suffered from 94 invasive secondary malignancies (30 haematologic malignancies, 64 solid tumours). In 29 patients a non-melanoma skin cancer was observed. 31/64 (48%) patients with solid tumours were diagnosed in an early stage of the disease (UICC 0-2) and had a chance of cure. 5% of the patients developed an invasive malignancy within 5 years, 12% within 10 years, 21% within 20 years. Risk factors were advanced age, the diagnosis lymphoma and in lymphoma patients additionally male sex.

Conclusions: Secondary malignancies after ASCT are relatively frequent complications. Our findings suggest that systematic life-long cancer screening after ASCT is essential to improve the prognosis of these adverse events.