Stem Cell Transplant Recipients Face Increased Skin Cancer Risks: Study

Researchers recommended doctors implement rigorous skin cancer surveillance and preventive strategies, especially for those on certain antibiotic medications.

A new study suggests that individuals undergoing hematopoietic stem cell transplantation (HSCT), whether from donor cells or their own cells, may be between seven and 10 times more likely to develop various types of skin cancer and related conditions.

In findings published in the International Journal of Dermatology, researchers examined the risk of skin cancer among stem cell transplant recipients, indicating that a significant increased risk was seen for the development of basal cell carcinoma and squamous cell carcinoma, when compared to the general population.

Hematopoietic stem cell transplantation, referred to in specific circumstances as a bone marrow transplant, comes in two forms known as allogeneic and autologous. An allogeneic stem cell transplant is a procedure in which patients receive healthy blood-forming cells (stem cells) from a donor to replace their existing stem cells.

An autologous transplant is a procedure in which the stem cells are obtained from the patient before treatment, are stored, and are then infused back into the patient post-treatment. HSCT is generally used to treat leukemia, lymphoma, sickle cell disease, and other blood disorders, usually after the patient’s original stem cells have been destroyed by radiation treatment or high doses of chemotherapy.

Stem Cell Transplant Cancer Risks

In the latest study led by Miguel Mansilla-Polo and colleagues, the researchers analyzed 26 studies involving 164,944 HSCT recipients to evaluate the risk of skin cancer post-treatment and the associated risk factors, including gender, chronic graft-versus-host disease (cGVHD), voriconazole exposure, and total body irradiation (TBI).

The team of researchers found a significantly increased risk of skin cancer in patients after they received HSCT. The standardized incidence ratio (SIR), which compares the risk in the study population to the general population, was 7.21 overall, indicating that HSCT recipients are more than seven times as likely to develop skin cancer compared to the general population.

However, both types of hematopoietic stem cell transplantation (HSCT) carried significant risks, according to research findings. The study showed that the risk of developing skin cancer more than doubled for those receiving autologous HSCT, where patients are treated with their own cells. For those receiving stem cells from donors, the risk of skin cancer increased more than ten times.

The data highlighted several major risk factors for complications following hematopoietic stem cell transplantation. One significant risk is chronic graft-versus-host disease (GVHD), a condition where donor cells attack the recipient’s body, with a hazard ratio of 2.86, indicating a nearly threefold increase in risk.

Additional risk factors include gender, with males experiencing higher rates of certain types of skin cancer, and exposure to voriconazole, an antifungal medication, which was linked to an increased risk of skin cancer.

The researchers emphasized the necessity for patients undergoing hematopoietic stem cell transplantation (HSCT) to be aware of the increased risks of skin cancer, a knowledge crucial for guiding treatment strategies.

“These findings highlight the importance of rigorous skin cancer surveillance and preventive strategies in HSCT recipients,” researchers concluded. “Particularly in male individuals undergoing allogeneic transplants.”