TriangleHEALTH PROFESSIONAL · SOURCE READING
Subsequent neoplasms after hematopoietic stem cell transplant (HSCT)
Source: Late Effects of Treatment for Childhood Cancer (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 14, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Context: Subsequent Neoplasms / Therapy-Related Solid SNs
Recipients of HSCT are treated with high-dose chemotherapy and, often, TBI, which makes their risk of SNs unique from that of the general oncology population.
Among 4,318 first-time allogeneic HSCT recipients treated for AML and chronic myeloid leukemia between 1986 and 2005, and conditioned with high-dose busulfan and cyclophosphamide (Bu-Cy), 66 solid cancers were reported at a median of 6 years post-HSCT.[31]
Source links and citations
Among 4,318 first-time allogeneic HSCT recipients treated for AML and chronic myeloid leukemia between 1986 and 2005, and conditioned with high-dose busulfan and cyclophosphamide (Bu-Cy), 66 solid cancers were reported at a median of 6 years post-HSCT.[31]
The cumulative incidence of new solid cancers was 0.9% at 5 years and 2.4% at 10 years and appears to be similar, regardless of exposure to radiation.
Among 4,318 first-time allogeneic HSCT recipients treated for AML and chronic myeloid leukemia between 1986 and 2005, and conditioned with high-dose busulfan and cyclophosphamide (Bu-Cy), 66 solid cancers were reported at a median of 6 years post-HSCT.[31]
Bu-Cy conditioning without TBI was associated with higher risks of solid SNs than in the general population.
Among 4,318 first-time allogeneic HSCT recipients treated for AML and chronic myeloid leukemia between 1986 and 2005, and conditioned with high-dose busulfan and cyclophosphamide (Bu-Cy), 66 solid cancers were reported at a median of 6 years post-HSCT.[31]
Chronic graft-versus-host disease increased the risk of SNs, especially those involving the oral cavity.
A study of 4,905 1-year survivors of allogeneic HSCT who underwent transplant between 1969 and 2014 for malignant or nonmalignant diseases, and were followed for a median 12.5 years, demonstrated a strong effect of TBI dose and dose fractionation on risk of SNs.[32]
Source links and citations
A study of 4,905 1-year survivors of allogeneic HSCT who underwent transplant between 1969 and 2014 for malignant or nonmalignant diseases, and were followed for a median 12.5 years, demonstrated a strong effect of TBI dose and dose fractionation on risk of SNs.[32]
The 20-year cumulative incidence of SN after HSCT for individuals treated at younger than 20 years was 8.1%.
A study of 4,905 1-year survivors of allogeneic HSCT who underwent transplant between 1969 and 2014 for malignant or nonmalignant diseases, and were followed for a median 12.5 years, demonstrated a strong effect of TBI dose and dose fractionation on risk of SNs.[32]
SN risk was highest in survivors exposed to high-dose, single-fraction TBI (6–12 Gy) or very high-dose fractionated TBI (14.4–17.5 Gy).
A study of 4,905 1-year survivors of allogeneic HSCT who underwent transplant between 1969 and 2014 for malignant or nonmalignant diseases, and were followed for a median 12.5 years, demonstrated a strong effect of TBI dose and dose fractionation on risk of SNs.[32]
With low-dose TBI (2–4.5 Gy), the SN risk was comparable to the risk with chemotherapy alone, although it was still twofold higher than in the general population.
A study of 4,905 1-year survivors of allogeneic HSCT who underwent transplant between 1969 and 2014 for malignant or nonmalignant diseases, and were followed for a median 12.5 years, demonstrated a strong effect of TBI dose and dose fractionation on risk of SNs.[32]
Among individuals treated at younger than 20 years, the number of SNs was 12.5-fold higher than expected in the general population, and the excess absolute risk was 10.6 per 1,000 person-years. Survivors treated with HSCT at this young age were more likely to develop SNs than were survivors who were treated after age 50 years (HR, 2.3).
Some well-established solid SNs are described in the following sections.
Publication references
Read the original reference and check its publication notices.
Preserved source evidence · Not medical advice