Long-term toxicities after allogeneic hematopoietic stem cell transplantation with or without total body irradiation: a population-based study in Korea

• 영문명: Long-term toxicities after allogeneic hematopoietic stem cell transplantation with or without total body irradiation: a population-based study in Korea
• 발행기관: 대한방사선종양학회
• 저자명: Jeanny Kwon Byoung Hyuck Kim
• 간행물 정보: 『대한방사선종양학회지』제42권 제1호, 50~62쪽, 전체 13쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2024.03.30

영문 초록

Purpose: To compare long-term toxicity incidences, including secondary cancer (SC) with or without total body irradiation (TBI), in Asian patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) using a nationwide database. Materials and Methods: We identified 4,554 patients receiving HSCT for leukemic disease from 2009 to 2016 using the healthcare bigdata system of Korea. Incidence rate ratios (IRRs) for SC, cataracts, hypothyroidism, chronic kidney disease (CKD), myocardial infarction, or strokes were compared, and standardized incidence ratios (SIR) of SC was also estimated. Results: TBI was conducted on 1,409 patients (30.9%). No overall survival differences based on TBI were observed. With a median follow-up duration of 58.2 months, 143 patients were diagnosed with subsequent SC (3.4%). Incidence rates per 1,000 person-year were 6.56 (95% confidence interval [CI], 4.8–8.8) and 7.23 (95% CI, 5.9–8.8) in the TBI and no-TBI groups, respectively (p = 0.594). Also, the SIR (95% CI) was not significantly increased by TBI (1.32 [0.86–1.94] vs. 1.39 [1.08–1.77] in the no-TBI group). In the young age group (0–19 years), SIRs were increased in both groups regardless of TBI (8.60 vs. 11.96). The IRRs of cataracts (1.60; 95% CI, 1.3–2.0), CKD (1.85; 95% CI, 1.3–2.6), and hypothyroidism (1.50; 95% CI, 1.1–2.1) were significantly increased after TBI. However, there were no significant differences in the occurrence of myocardial infarction and stroke according to TBI. Conclusion: Our results suggest that modern TBI may not additionally increase the risk of SC after allogeneic HSCT, although increased risks of other diseases were noted. Physicians should carefully consider individualized risks and benefits of TBI, with a particular focus by age group.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Funding

Author Contributions

Data Availability Statement

Supplementary Materials

References

키워드

Hematopoietic stem-cell transplantation Secondary malignancy Total body irradiation Whole-body irradiation Cataract Chronic renal insufficiency