Bone marrow transplant survivors face risk of HPV-linked cancers
December 10, 2012 | by Roberta Nichols
Bone marrow transplant and peripheral blood transplant survivors are at increased risk of developing cancers of the tongue, mouth and throat, as well as cancers of the cervix – cancers typically linked to the human papillomavirus (HPV), City of Hope researchers have found.
The risk is highest among survivors who have undergone an unrelated donor transplant (requiring high-intensity therapy) and those who developed chronic graft-versus-host disease, researchers discovered.
They presented their research at the American Society of Hematology (ASH) meeting in Atlanta Dec. 8 to 11.
According to the federal Centers for Disease Control and Prevention, 26,000 cancers diagnosed each year in the general population are attributable to HPV and oral/pharangeal and female genital cancers account for 75 percent of these cases.
Researchers suspected that bone marrow and peripheral blood transplant recipients are at an especially increased risk of acquiring new cancers linked to HPV due to their suppressed immune systems and exposure to high-intensity chemotherapy.
“We took a cohort of over 5,000 patients who had undergone transplants at City of Hope, followed them long-term, and showed quite clearly that our transplant survivors were at a five-to-six fold increased risk of developing both oral/pharangeal cancer as well as female genital tract tumors,” said senior author Smita Bhatia, M.D., M.P.H., director, Center for Cancer Survivorship at City of Hope.
The study demonstrates that aggressive screening for oral/pharangeal cancer and female genital tract tumors is crucial, especially in those who have undergone a transplant or who developed graft-versus-host disease, said Bhatia, the Ruth Ziegler Chair in Population Sciences at City of Hope.
Chronic graft-versus-host disease significantly increases risk of oral and female genital tract tumors, said Bhatia. In fact, more than 90 percent of post-HCT female genital tract tumors are linked to HPV.
“Clinically this information is important because of the ability to institute primary prevention (HPV) vaccine for those under 26, and the need to develop targeted surveillance and intervention strategies across all age groups,” said lead author Jennifer Berano Teh, M.D., clinical research assistant, Division of Outcomes Research/Intervention at City of Hope.
City of Hope researchers are continuing to explore which HPV strains are most likely to cause disease in transplant survivors, whether the HPV vaccine would be safe in transplant survivors and whether it would work as effectively as it does in the general population.
This study is supported by a National Institutes of Health grant (R01 CA 139633).