Treatment of solid tumors following allogeneic bone marrow transplantation

Second solid tumors are well known late complications after bone marrow tra nsplantation. Treatment strategies are ill defined. We retrospectively eval uated treatment and outcome in a single institution. From August 1974 to Ju ly 1996, six solid tumors were observed in five of 387 patients 2 to 13 yea rs after BMT, corresponding to a probability of developing a second solid t umor of 9% (1-17%, 95 CI) at 15 years: these comprised endometrial carcinom a, carcinoma of the thyroid gland, cervical carcinoma, sarcoma of the small intestine, osteosarcoma of the tibia and ovarian carcinoma. All five patie nts were treated as intensively as they would be without a history of BMT. At last follow-up four of the five patients were alive and without signs of tumor. We postulate that second solid tumors after BMT should be treated a s de novo tumors. Early detection based on consequent clinical follow-up of the transplant patients might explain the relatively good outcome.