Risk factors for second solid cancers, by site of second cancer, among survivors for 1 or more years after HCT
| Variable . | Thyroid (n = 13) . | Bone/connective tissue (n = 12) . | Brain, CNS (n = 15) . | Female breast (n = 13) . | Melanoma of the skin (n = 18) . | SCC skin (n = 18) . | SCC oral cavity (n = 24) . | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | |
| Radiation conditioning | 12 | 5.7‡ | 11 | 5.9‡ | 15 | ∞‡§ | 12 | 5.8‡ | 18 | ∞‡§ | 8 | 0.4 | 17 | 0.8 |
| LFI | 1 | 1.7 | 0 | 0.0 | 0 | 0.0 | 1 | 4.6 | 0 | 0.0 | 1 | 1.8 | 4 | 4.7‡ |
| T-cell dep. | 1 | 1.2 | 2 | 2.3 | 0 | 0.0 | 0 | 0.0 | 6 | 3.5‡ | 1 | 0.7 | 2 | 1.0 |
| Male sex | 4 | 0.3 | 6 | 0.8 | 12 | 3.0 | NA | NA | 5 | 0.3‡ | 17 | 11.9‡ | 19 | 2.8‡ |
| Acute GVHD* | 4 | 1.0 | 2 | 0.5 | 6 | 1.7 | 1 | 0.2‡ | 5 | 0.9 | 8 | 2.0 | 8 | 1.1 |
| Chronic GVHD† | 1 | 0.3 | 1 | 0.3 | 1 | 0.3 | 3 | 0.8 | 2 | 0.4 | 14 | 11.0‡ | 16 | 5.3‡ |
| HLA mis/unrel | 1 | 0.6 | 1 | 0.7 | 3 | 1.6 | 1 | 0.9 | 2 | 1.0 | 1 | 0.6 | 1 | 0.5 |
| ATG | 0 | 0.0 | 0 | 0.0 | 1 | 0.8 | 2 | 3.3 | 1 | 1.0 | 1 | 0.7 | 2 | 1.3 |
| Variable . | Thyroid (n = 13) . | Bone/connective tissue (n = 12) . | Brain, CNS (n = 15) . | Female breast (n = 13) . | Melanoma of the skin (n = 18) . | SCC skin (n = 18) . | SCC oral cavity (n = 24) . | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | No. . | RR . | |
| Radiation conditioning | 12 | 5.7‡ | 11 | 5.9‡ | 15 | ∞‡§ | 12 | 5.8‡ | 18 | ∞‡§ | 8 | 0.4 | 17 | 0.8 |
| LFI | 1 | 1.7 | 0 | 0.0 | 0 | 0.0 | 1 | 4.6 | 0 | 0.0 | 1 | 1.8 | 4 | 4.7‡ |
| T-cell dep. | 1 | 1.2 | 2 | 2.3 | 0 | 0.0 | 0 | 0.0 | 6 | 3.5‡ | 1 | 0.7 | 2 | 1.0 |
| Male sex | 4 | 0.3 | 6 | 0.8 | 12 | 3.0 | NA | NA | 5 | 0.3‡ | 17 | 11.9‡ | 19 | 2.8‡ |
| Acute GVHD* | 4 | 1.0 | 2 | 0.5 | 6 | 1.7 | 1 | 0.2‡ | 5 | 0.9 | 8 | 2.0 | 8 | 1.1 |
| Chronic GVHD† | 1 | 0.3 | 1 | 0.3 | 1 | 0.3 | 3 | 0.8 | 2 | 0.4 | 14 | 11.0‡ | 16 | 5.3‡ |
| HLA mis/unrel | 1 | 0.6 | 1 | 0.7 | 3 | 1.6 | 1 | 0.9 | 2 | 1.0 | 1 | 0.6 | 1 | 0.5 |
| ATG | 0 | 0.0 | 0 | 0.0 | 1 | 0.8 | 2 | 3.3 | 1 | 1.0 | 1 | 0.7 | 2 | 1.3 |
Analyses were based 165 solid cancers including 18 invasive squamous cell carcinomas (SCC) of the skin and 13 nonskin carcinomas in situ. Poisson regression models were stratified by age (< 10, 20-29, 30-39, 40-49, ≥ 50 y), and latency (1 to < 5, 5 to < 10, 10 to < 15, ≥ 15 y after HCT); patients with unknown radiation or unknown radiation dose are excluded. The table presents univariate relative risks for variables with P > .05, and multivariate relative risks, adjusted for other significant risk factors, for variables that are statistically significant. No. indicates number of observed cases of second cancers; dep, depletion; HLA mis/unrel, 2 or more HLA antigen mismatches with a sibling, related, or unrelated donor; ATG, antithymocyte globulin to prevent or to treat acute GVHD; and NA, not applicable.
Acute GVHD was grades II-IV.
Chronic GVHD was moderate or severe grade in CIBMTR patients, or clinically extensive in FHCRC patients.
P < .05.
An RR of ∞ indicates a confidence interval with a lower limit greater than 1.0 but an upper limit that is unbounded or indeterminate (∞), because all cases were exposed to the risk factor of interest.