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<p>Despite the increasing number of cancer survivors, the impact of prior solid tumors and their treatment modality on outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. This multi-center retrospective study compared transplant outcomes in allo-HSCT recipients with and without a history of solid tumors. Of 5,850 adult patients who underwent first allo-HSCT, 303 (5.2%) had a prior solid tumor. After propensity score matching, overall survival (OS) and cumulative incidences of relapse, non-relapse mortality (NRM), and acute and chronic graft-versus-host diseases were almost comparable between the two groups. Progression or recurrence of solid tumors after allo-HSCT occurred in only eight cases (2.8%). Importantly, patients who received both chemotherapy and radiation therapy (Chemo + RT) for prior solid tumors had significantly worse OS (35.3% vs. 54.1% [<i>P</i> &lt; 0.001] vs. 56.8% [<i>P</i> &lt; 0.001] at 2 years) and higher NRM (36.2% vs. 18.7% [<i>P</i> = 0.002] vs. 19.3% [<i>P</i> = 0.001] at 2 years) compared to patients who received other treatment modalities for prior solid tumors or patients without prior solid tumors. These findings highlight the feasibility of allo-HSCT in selected patients with prior solid tumors, while demonstrating the negative impact of Chemo + RT on outcomes after allo-HSCT.</p>

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Impact of prior solid tumors and their treatment modality on outcomes after allogeneic hematopoietic stem cell transplantation

  • 期刊论文

  • 发表日期：

    2025年9月15日

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  • Takayuki Fujii,
  • Masatoshi Sakurai,
  • Hiroaki Shimizu,
  • Akihiko Izumi,
  • Kenji Kimura,
  • Katsuhiro Shono,
  • Susumu Tanoue,
  • Yosuke Okada,
  • Shinichi Kako,
  • Shinichiro Matsui,
  • Emiko Sakaida,
  • Atsushi Jinguji,
  • Fumihiko Ouchi,
  • Yuho Najima,
  • Takeshi Kobayashi,
  • Takayoshi Tachibana,
  • Masatsugu Tanaka,
  • Shino Iwata,
  • Makoto Onizuka,
  • Shingo Yano,
  • Kaoru Hatano,
  • Maki Hagihara,
  • Nobuyuki Aotsuka,
  • Shin Fujisawa,
  • Satoshi Takahashi,
  • Nobuhiko Kobayashi,
  • Taku Kikuchi,
  • Keisuke Tanaka,
  • Keisuke Kataoka,
  • Yoshinobu Kanda

摘要

Despite the increasing number of cancer survivors, the impact of prior solid tumors and their treatment modality on outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. This multi-center retrospective study compared transplant outcomes in allo-HSCT recipients with and without a history of solid tumors. Of 5,850 adult patients who underwent first allo-HSCT, 303 (5.2%) had a prior solid tumor. After propensity score matching, overall survival (OS) and cumulative incidences of relapse, non-relapse mortality (NRM), and acute and chronic graft-versus-host diseases were almost comparable between the two groups. Progression or recurrence of solid tumors after allo-HSCT occurred in only eight cases (2.8%). Importantly, patients who received both chemotherapy and radiation therapy (Chemo + RT) for prior solid tumors had significantly worse OS (35.3% vs. 54.1% [P < 0.001] vs. 56.8% [P < 0.001] at 2 years) and higher NRM (36.2% vs. 18.7% [P = 0.002] vs. 19.3% [P = 0.001] at 2 years) compared to patients who received other treatment modalities for prior solid tumors or patients without prior solid tumors. These findings highlight the feasibility of allo-HSCT in selected patients with prior solid tumors, while demonstrating the negative impact of Chemo + RT on outcomes after allo-HSCT.