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Malignancy after hematopoietic cell transplantation

Robert S Negrin, MD
Section Editor
Nelson J Chao, MD
Deputy Editor
Alan G Rosmarin, MD


The success of hematopoietic cell transplantation (HCT) has led to the unfortunate complication of secondary malignancies in patients who would otherwise be long-term survivors. Among the malignancies are solid tumors, acute leukemia, myelodysplastic syndromes, and post-transplant lymphoproliferative disease (PTLD). While the former occur late in the post-transplant course (>3 years post transplant), PTLD usually occurs in the first year after transplantation [1]. (See "Epidemiology, clinical manifestations, and diagnosis of post-transplant lymphoproliferative disorders".)

The risk for development of secondary malignancies following HCT will be reviewed here. Other complications of HCT and the development of secondary malignancies following solid organ transplantation are discussed separately. (See "The approach to hematopoietic cell transplantation survivorship" and "Hematopoietic support after hematopoietic cell transplantation" and "Management of the hematopoietic cell transplant recipient in the immediate post-transplant period" and "Development of malignancy following solid organ transplantation".)


Patients treated with chemotherapy and/or radiotherapy followed by hematopoietic cell transplantation (HCT) have an increased risk of developing myelodysplastic syndrome, acute leukemia, post-transplant lymphoproliferative disease, and solid tumors when compared with the general population [2-11]. These cancers are expected to have a significant impact upon survival in this patient population. The relative risk of developing a malignancy following HCT has varied greatly among studies and is dependent upon a number of patient and treatment factors, including:

Radiation dose and fields

Chemotherapy agents and doses administered

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Literature review current through: Nov 2017. | This topic last updated: May 24, 2017.
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