Malignancy post-hematopoietic stem cell transplant in patients with primary immunodeficiency

Expert Rev Clin Immunol. 2020 May;16(5):493-511. doi: 10.1080/1744666X.2020.1763792. Epub 2020 May 22.

Abstract

Introduction: Hematopoietic cell transplantation (HCT) is a curative treatment for an expanding number of primary immunodeficiencies (PIDs). Malignancies are more common in patients with PID than in the general population, and this review will discuss whether a successful HCT is expected to abolish or alter this risk. Second malignancy post HCT for a malignant disease is well known to occur, but generally less expected in patients transplanted for PID.

Areas covered: This article reviews recently published literature focusing on the pattern of malignancy in children with PID, incidence, and risk factors for developing malignancy post-HCT for PID and possible strategies to reduce the risks.

Expert opinion: Survival post HCT for PID has improved dramatically in the last 20 years and the genomic revolution has led to an expanding number of indications. To improve long-term quality of life attention needs to focus on late effects, including the possibility of malignancy occurring more frequently than expected in the general population, understand the risks and improve the process of transplantation in order to minimize them. Further studies are needed.

Keywords: Hematopoietic cell transplantation; malignancy; primary immunodeficiency.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Allografts
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Neoplasms* / etiology
  • Neoplasms* / immunology
  • Primary Immunodeficiency Diseases* / immunology
  • Primary Immunodeficiency Diseases* / therapy
  • Quality of Life*
  • Transplantation Conditioning / adverse effects*