Oral carcinoma after hematopoietic stem cell transplantation: A report of four cases and a review of cases reported in Japan

Abstract

Patients with hematopoietic malignancies who have undergone hematopoietic stem cell transplantation （HSCT） are prone to develop oral cancer. We have experienced four cases of oral cancer after HSCT. In this study, we examined 47 cases, including 43 cases reported in Japan and our four cases.
The hematopoietic malignancies of the four patients were two cases of acute myelogenous leukemia, a case of myelodysplastic syndrome, and a case of follicular lymphoma. Two patients underwent peripheral blood stem cell transplant, one patient underwent bone marrow transplant, and one patient underwent cord blood transplant. Two of the four patients developed chronic oral GVHD after HSCT. Three patients underwent surgery, and one patient underwent definitive radiotherapy for oral cancer. The prognosis was that only one patient survived; the remaining patients died of oral cancer, hematologic diseases, and other causes.
A review of the literature found that 24.2％ of patients with oral cancer occurring after HSCT died within 5 years of diagnosis. In addition to recurrence and metastasis, the incidence of multiple cancers in the oral cavity was high, with 11 cases （33.3％）, suggesting the need for strict follow-up. Sequelae of HSCT such as bronchiolitis obliterans and a history of total-body irradiation may limit the treatment of oral cancer, so close follow-up is necessary to enable treatment to be started at an early stage of carcinogenesis.