Post-hematopoietic stem cell transplant squamous cell carcinoma in patients with Fanconi anemia: a dreadful enemy

Introduction Hematopoietic stem cell transplantation (HSCT) is a curative option for patients with Fanconi anemia (FA) and hematological manifestations but it does not prevent solid tumors, especially squamous cell carcinomas (SCC). Methods Retrospective study in 22 FA patients who had received HSCT and had been followed up beyond 2 years after HSCT. Results The median follow-up was 15 years. Six patients developed head-and-neck SCC after transplantation. The cumulative incidence of SCC at 15 and 30 years from the HSCT was 14.2% and 71.2%, respectively. One patient was diagnosed in stage IV and the rest, who were being followed up in cancer screening programs, in stage I. Treatment of SCC consisted of surgery in all patients; radiotherapy and chemotherapy were used in two patients and were poorly tolerated. Conclusion FA patients have high risk of head-and-neck SCC. Multi-disciplinary programs for early cancer detection are of special relevance in these patients.

Automated summary

HSCT is a curative option for FA patients with hematological manifestations, but does not prevent solid tumors such as head-and-neck SCC. Long-term follow-up showed a high cumulative incidence of SCC in FA patients, highlighting the importance of multidisciplinary cancer screening programs.