Читать книгу Blood and Marrow Transplantation Long Term Management - Группа авторов - Страница 161

While thyroid carcinoma is generally considered a prototype of radiation‐induced carcinoma, data from the European group strongly suggest that cGVHD may play a role in the genesis of this cancer. We performed a retrospective analysis comparing data obtained by means of a two‐step questionnaire from the 166 centers who replied, and data reported to the European Group for Blood and Marrow Transplantation (EBMT) registry on their transplantation activity [67]. During the follow‐up period (1985 to 2003), 32 instances of thyroid carcinoma were found within the EBMT cohort of 68#936 patients who received HSCT. The standardized incidence ratio of thyroid carcinoma in the transplant population was 3.26, in comparison with the general European population. Multivariate analysis revealed that young age at HSCT was the strongest risk factor (relative risk [RR], 24.61 for ages 0 to 10 years; RR, 4.80 for ages 11 to 20 years). Other risk factors were irradiation (RR, 3.44), female sex (RR, 2.79), and cGVHD (RR, 2.94). Nine patients showed no clinical signs of thyroid disease at diagnosis. Total thyroidectomy and iodine ablation were the standard treatment for the majority of patients, and only one patient died due to cancer progression.