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Cutaneous Malignant Neoplasms in Hematopoietic Cell Transplant Recipients A Systematic Review

Jennifer L. DePry, DO1; Ritva Vyas, MBChB, FRACP1,2; Hillard M. Lazarus, MD2,3; Paolo F. Caimi, MD2,3; Meg R. Gerstenblith, MD1,2; Jeremy S. Bordeaux, MD, MPH1,2
[+] Author Affiliations
1Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio
2Case Comprehensive Cancer Center, Cleveland, Ohio
3Division of Hematology and Oncology, Department of Internal Medicine, University Hospitals Case Medical Center, Cleveland, Ohio
JAMA Dermatol. 2015;151(7):775-782. doi:10.1001/jamadermatol.2015.121.
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Importance  Hematopoietic cell transplantation has increased the survival of patients with several types of malignant hematologic disease and hematologic disorders; however, these patients have an increased risk of posttransplant cutaneous malignant neoplasms. Physicians should be aware of associated risk factors to provide appropriate patient screening and long-term care.

Objective  To identify the incidence and risk factors for cutaneous malignant neoplasms following hematopoietic cell transplantation.

Evidence Review  A systematic review was conducted using Medline and Cochrane databases from January 1995 to December 2013. Retrospective and prospective reviews containing at least 100 patients who underwent hematopoietic cell transplantation reporting skin cancer as a primary outcome were included. Information regarding the entire cohort, data for the subset who developed cutaneous malignant neoplasms, and cutaneous malignant neoplasm risk factors were extracted from included articles. The level of evidence for each study was assessed using the Strength of Recommendation Taxonomy scale.

Findings  Patients who underwent hematopoietic cell transplantation had an increased risk of squamous cell carcinoma, basal cell carcinoma, and melanoma. Factors such as primary disease, chronic graft-vs-host disease, prolonged immunosuppression, radiation exposure, light skin color, sex, and T-cell depletion are risk factors for cutaneous malignant neoplasms.

Conclusions and Relevance  Given the increased risk of cutaneous malignant neoplasms in hematopoietic cell transplant recipients, this population should be educated on skin self-examination and pursue regular follow-up with dermatologists.

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