A RECENT cohort study has revealed that survivors of blood or marrow transplant (BMT) face a significantly higher risk of developing skin cancer compared to the general population. The study, which involved 3,880 BMT survivors, found a 30-year cumulative incidence of 27.4% for cutaneous malignant neoplasms, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Among these, BCC was the most common (18%), followed by SCC (9.8%) and melanoma (3.7%).
Several risk factors for skin cancer were identified, including being over 50 years old at the time of the transplant, chronic graft-versus-host disease (cGVHD) in allogeneic BMT recipients, prior exposure to monoclonal antibodies, and ongoing immunosuppression after the transplant. Survivors who had their transplant at City of Hope or the University of Alabama at Birmingham had a higher risk of skin cancer compared to those treated at the University of Minnesota.
The study also found that certain racial and ethnic groups, including Black and Hispanic patients, had a lower incidence of BCC and SCC. Furthermore, total body irradiation (TBI) was associated with an increased risk of BCC in patients under 50 years old at the time of transplant.
These findings highlight the need for tailored counselling and regular dermatological monitoring for BMT survivors, as the study underscores the elevated long-term risk of skin cancers in this group.
Helena Bradbury, EMJ
Reference
Broman KK et al. Incidence of and risk factors for cutaneous malignant neoplasms after blood or marrow transplant. JAMA Dermatol. 2024; doi: 10.1001/jamadermatol.2024.5129.
