Abstract
Despite the increasing number of cancer survivors, the impact of prior solid tumors and their treatment modality on outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. This multi-center retrospective study compared transplant outcomes in allo-HSCT recipients with and without a history of solid tumors. Of 5,850 adult patients who underwent first allo-HSCT, 303 (5.2%) had a prior solid tumor. After propensity score matching, overall survival (OS) and cumulative incidences of relapse, non-relapse mortality (NRM), and acute and chronic graft-versus-host diseases were almost comparable between the two groups. Progression or recurrence of solid tumors after allo-HSCT occurred in only eight cases (2.8%). Importantly, patients who received both chemotherapy and radiation therapy (Chemo + RT) for prior solid tumors had significantly worse OS (35.3% vs. 54.1% [P < 0.001] vs. 56.8% [P < 0.001] at 2 years) and higher NRM (36.2% vs. 18.7% [P = 0.002] vs. 19.3% [P = 0.001] at 2 years) compared to patients who received other treatment modalities for prior solid tumors or patients without prior solid tumors. These findings highlight the feasibility of allo-HSCT in selected patients with prior solid tumors, while demonstrating the negative impact of Chemo + RT on outcomes after allo-HSCT.
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Data availability
The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors thank all patients who participated in the study and all members of Kanto Study of Group for Cell Therapy (KSGCT). The authors also thank Toyohiro Kawano and the members of the KSGCT data center for data management.
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TF, MS and KK designed the study, performed the analyses, and wrote the manuscript. HS, AI, KK, KS, ST, YO, SK, SM, ES, AJ, FO, YN, TK, TT, MS, SI, MO, SY, KH, MH, NA, SF, ST, NK, TK and KT contributed to data collection and revised the manuscript. KK and YK supervised the study. All authors discussed the results and reviewed the manuscript.
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KK received honoraria from Ono Pharmaceutical, Eisai, Astellas Pharma, Novartis, Chugai Pharmaceutical, AstraZeneca, Sumitomo Pharma, Kyowa Kirin, Janssen Pharmaceutical, Takeda Pharmaceutical, Otsuka Pharmaceutical, SymBio Pharmaceuticals, Bristol Myers Squibb, Pfizer, Nippon Shinyaku, Daiichi Sankyo, Alexion Pharmaceuticals, AbbVie, Meiji Seika Pharma, Sanofi, Sysmex, Mundipharma, Incyte Corporation, and Kyorin Pharmaceutical. KK received research support from Otsuka Pharmaceutical, Chordia Therapeutics, Chugai Pharmaceutical, Takeda Pharmaceutical, and Meiji Seika Pharma. KK received scholarship from Asahi Kasei Pharma, Eisai, Otsuka Pharmaceutical, Ono Pharmaceutical, Kyowa Kirin, Shionogi, Takeda Pharmaceutical, Sumitomo Dainippon Pharma, Chugai Pharmaceutical, Teijin Pharma, Japan Blood Products Organization, Mochida Pharmaceutical, JCR Pharmaceuticals, and Nippon Shinyaku. KK owns stock in Asahi Genomics. KK has a patent for Genetic alterations as a biomarker in T-cell lymphomas and a patent for PD-L1 abnormalities as a predictive biomarker for immune checkpoint blockade therapy. SF reports honoraria from Bristol-Myers-Squibb, Nippon Shinyaku, Otsuka Pharmaceutical Co., Ltd., Pfizer Japan Inc., Novartis Pharma KK, Janssen, Kyowa Kirin Co., Ltd., AstraZeneca, CSL Behring K.K, Meiji Seika Pharma, AbbVie Inc, Takeda Pharmaceutical Co., Ltd., Asahi Kasei Pharma Co., Ltd., Daiichi Sankyo Co., Ltd., Kissei, PharmaEssentia Japan, Genmab, Argenx Japan, Alexion Pharma, Inc., and Chugai Pharmaceutical Co., Ltd. and research funding from Shionogi Co., Ltd., Chugai Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Asahi-Kasei Pharma, and Daiichi Sankyo Co., Ltd., outside of the submitted work.
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This study was conducted in accordance with the Declaration of Helsinki and was approved by the ethics committee of Keio University School of Medicine (Tokyo, Japan) (approval number 20231134). All patients provided informed consent for the use of their clinical data for research purposes. No identifiable images or other personal details of participants are presented in this manuscript.
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Fujii, T., Sakurai, M., Shimizu, H. et al. Impact of prior solid tumors and their treatment modality on outcomes after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant (2025). https://doi.org/10.1038/s41409-025-02718-8
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DOI: https://doi.org/10.1038/s41409-025-02718-8
