Incidence and Risk Factors of Skin Cancer and Preneoplastic Lesions after Autologous and Allogeneic Hematopoietic Cell Transplantation.

Publication date: Jul 04, 2025

Although an increased risk of skin cancer has been documented in recipients of allogeneic hematopoietic stem cell transplantation (HCT), there is still a paucity of information regarding its specific risk factors in the contemporaneous era, as well as its frequency after autologous HCT. The objective of this single-center study was to analyze separately the incidence, characteristics, and risk factors of skin cancer and its precursor actinic keratosis (AK) in a large contemporary cohort of allogeneic and autologous HCT recipients during a study period spanning from 2007 to 2023. This observational, unicentric cohort study included all patients who underwent autologous or allogeneic HCT at a tertiary hospital. The study included 2,042 patients, 1,182 allogeneic and 860 autologous. The median follow-up for surviving patients was 61 months (interquartile range, 25-91). Sixty-seven skin cancers were recorded, with a median interval to diagnosis of 35. 4 months. The most common cancer lesions detected were basal cell carcinoma (51%) followed by squamous cell carcinoma (31%), and melanoma (13%). The cumulative incidence of skin cancer at 6 years was 4% (95% CI, 2. 9 – 5. 3), being 6. 1% (95% CI, 3. 5 – 9. 6) in autologous and 3. 2% (95% CI, 2. 2 – 4. 6) in allogeneic HCT recipients (p < 0. 001). Increased recipient age (hazard ratio [HR] 1. 6, 95% CI 1. 3-2. 0, p < 0. 001), male sex (HR 2. 2, 95% CI 1. 4-3. 6, p = 0. 001), and a history of prior skin cancer (HR 6. 3, 95% CI 3. 3-12. 2, p

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