Subsequent malignancies after long-term follow-up of paediatric hematopoietic stem cell transplantation

array:25 ["pii" => "S2341287918301686" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.10.002" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2500" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;90:157-64" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 910 "formatos" => array:3 [ "EPUB" => 102 "HTML" => 557 "PDF" => 251 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S1695403318303187" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2018.05.023" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2500" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;90:157-64" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2518 "formatos" => array:3 [ "EPUB" => 190 "HTML" => 1708 "PDF" => 620 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL" "titulo" => "Neoplasias malignas secundarias después de un trasplante de progenitores hematopoyéticos en edad pediátrica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "157" "paginaFinal" => "164" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Subsequent malignancies after long-term follow-up of pediatric hematopoietic stem cell transplantation" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1010 "Ancho" => 1520 "Tamanyo" => 76795 ] ] "descripcion" => array:1 [ "es" => "Incidencia acumulada de NMS." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luisa Sisinni, Ignasi Gich, Monserrat Torrent, Isabel Badell" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luisa" "apellidos" => "Sisinni" ] 1 => array:2 [ "nombre" => "Ignasi" "apellidos" => "Gich" ] 2 => array:2 [ "nombre" => "Monserrat" "apellidos" => "Torrent" ] 3 => array:2 [ "nombre" => "Isabel" "apellidos" => "Badell" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287918301686" "doi" => "10.1016/j.anpede.2018.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287918301686?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318303187?idApp=UINPBA00005H" "url" => "/16954033/0000009000000003/v2_202009040640/S1695403318303187/v2_202009040640/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2341287919300055" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.03.011" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2433" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;90:165-72" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1215 "formatos" => array:3 [ "EPUB" => 88 "HTML" => 842 "PDF" => 285 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Consumption of free sugars and excess weight in infants. A longitudinal study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "165" "paginaFinal" => "172" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ingesta de azúcares libres y exceso de peso en edades tempranas. Estudio longitudinal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1839 "Ancho" => 2344 "Tamanyo" => 191691 ] ] "descripcion" => array:1 [ "en" => "Percentage of total energy contributed by free sugars (FSs) and natural sugars at age 12 months by weight status at age 30 months." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cristina Jardí, Núria Aranda, Cristina Bedmar, Blanca Ribot, Irene Elias, Estefania Aparicio, Victoria Arija" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Cristina" "apellidos" => "Jardí" ] 1 => array:2 [ "nombre" => "Núria" "apellidos" => "Aranda" ] 2 => array:2 [ "nombre" => "Cristina" "apellidos" => "Bedmar" ] 3 => array:2 [ "nombre" => "Blanca" "apellidos" => "Ribot" ] 4 => array:2 [ "nombre" => "Irene" "apellidos" => "Elias" ] 5 => array:2 [ "nombre" => "Estefania" "apellidos" => "Aparicio" ] 6 => array:2 [ "nombre" => "Victoria" "apellidos" => "Arija" ] 7 => array:1 [ "colaborador" => "Grupo investigador DeFensas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S169540331830153X" "doi" => "10.1016/j.anpedi.2018.03.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331830153X?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300055?idApp=UINPBA00005H" "url" => "/23412879/0000009000000003/v1_201903020636/S2341287919300055/v1_201903020636/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2341287918301431" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.05.003" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2486" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;90:148-56" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2955 "formatos" => array:3 [ "EPUB" => 126 "HTML" => 2441 "PDF" => 388 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Real-world effectiveness of ivacaftor in children with cystic fibrosis and the G551D mutation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "148" "paginaFinal" => "156" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectividad de ivacaftor en vida real en niños con fibrosis quística y mutación G551D" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "David Gomez-Pastrana, Chinedu Nwokoro, Mike McLean, Sarah Brown, Nanna Christiansen, Caroline S. Pao" "autores" => array:6 [ 0 => array:2 [ "nombre" => "David" "apellidos" => "Gomez-Pastrana" ] 1 => array:2 [ "nombre" => "Chinedu" "apellidos" => "Nwokoro" ] 2 => array:2 [ "nombre" => "Mike" "apellidos" => "McLean" ] 3 => array:2 [ "nombre" => "Sarah" "apellidos" => "Brown" ] 4 => array:2 [ "nombre" => "Nanna" "apellidos" => "Christiansen" ] 5 => array:2 [ "nombre" => "Caroline S." "apellidos" => "Pao" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403318303047" "doi" => "10.1016/j.anpedi.2018.05.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318303047?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287918301431?idApp=UINPBA00005H" "url" => "/23412879/0000009000000003/v1_201903020636/S2341287918301431/v1_201903020636/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Subsequent malignancies after long-term follow-up of paediatric hematopoietic stem cell transplantation" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "157" "paginaFinal" => "164" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luisa Sisinni, Ignasi Gich, Montserrat Torrent, Isabel Badell" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Luisa" "apellidos" => "Sisinni" "email" => array:1 [ 0 => "lsisinni@santpau.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ignasi" "apellidos" => "Gich" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Montserrat" "apellidos" => "Torrent" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Isabel" "apellidos" => "Badell" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Pediatric Hematology, Oncology and HSCT Unit, Santa Creu i Sant Pau University Hospital, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Clinical Epidemiology Department, Santa Creu i Sant Pau University Hospital, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neoplasias malignas secundarias después de un trasplante de progenitores hematopoyéticos en edad pediátrica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1010 "Ancho" => 1520 "Tamanyo" => 76410 ] ] "descripcion" => array:1 [ "en" => "Cumulative incidence of SMNs." ] ] ] "textoCompleto" => "IntroductionHematopoietic stem cell transplantation (HSCT) can cure several malignant and nonmalignant diseases, congenital and acquired, in paediatric and adult patients. In recent years, advances in the procedure and in associated supportive therapies have resulted in an increase in long-term survival. Unfortunately, an increased risk of subsequent malignant neoplasms (SMN) has also been described in this group of patients. There are few reports in which the studied population is exclusively paediatric. The studies of Curtis et al.<a class="elsevierStyleCrossRef" href="#bib0085">1</a> in 1997 and the study of Socié et al.<a class="elsevierStyleCrossRef" href="#bib0090">2</a> in 2000 reported that the risk of SMN was 36-fold and 45-fold, respectively, in children that had undergone HSCT. Both studies found an inverse correlation between the risk of a late malignancy and age.In our study, we analysed the incidence of SMN in patients that underwent HSCT in our paediatric unit and the associated risk factors. Analysing the risk factors related to the development of these malignancies is crucial for the purpose of improving the conditioning regimens and supportive therapies associated with HSCT.Patients and methodsThe cohort under study comprised 371 patients that underwent HSCT (autologous or allogeneic) between 1984 and 2013 at the Paediatric HSCT Unit of our hospital. We analysed a total of 434 transplants, which amounted to all the HSCTs performed in our unit between 1984 and 2013. There were no losses to follow-up. Of the 371 patients, 63 received more than one transplant: 2 HSCTs (n=58) or 3 HSCTs (n=5). We obtained the informed consent of the legal guardians for the HSCT procedure and subsequent studies. We collected data on patient characteristics, HSCT type, and clinical outcomes prospectively in a database designed for the purpose. We finished collecting outcome data on September 30, 2016. The duration of follow-up was 30 years. We contacted all adult patients discharged from follow-up at our hospital to obtain information about their current vital status and complications such as malignancies. All the secondary malignancies had been diagnosed in our hospital, so we were able to review the pertinent diagnostic test and patient health records. The median age of the patients at the time of transplantation was 8.4 years (0.1–20 years), and 9 patients were aged more than 18 years. Of all patients, 226 (60.9%) were male and 145 (39.1%) female.The indication for HSCT was a malignant disease in 317 patients (85.4%) and a nonmalignant disease in 54 patients (14.6%). The malignant diseases included blood tumours (n=209) and solid tumours (n=108). The nonmalignant diseases included primary immunodeficiencies (n=20), aplastic anaemias (n=11), congenital bone marrow failures (n=8), hemoglobinopathies (n=8) and metabolic diseases (n=7). The disease status at the time of transplantations in patients with malignant disease was first complete remission in 146 patients, second complete remission in 101 patients and advanced stage or refractory disease in 7 patients. The HSCT was autologous in 234 cases (53.9%) and allogeneic in 200 cases (46.1%). The donor was a related donor in 141 cases (32.5%) and an unrelated donor in 59 cases (13.6%). As for HLA compatibility, the donor of allogeneic transplants was a matched sibling donor in 106 cases, a haploidentical donor in 35 cases, a matched unrelated donor in 23 cases, and a mismatched unrelated donor in 36 cases.The most frequent source of hematopoietic stem cells was bone marrow (68.7%; n=298) followed by mobilized peripheral blood (23.7%; n=103) and umbilical cord blood (5.8%; n=25). A combination of different sources (cord blood plus bone marrow or peripheral blood) was used in 8 transplants. The conditioning regimen was based on total body irradiation (TBI) in 48.2% of the HSCTs (n=209). The fractionated irradiation dose ranged between 10 and 13.5Gy in most cases (n=190). Few patients received a dose lower than 10Gy (n=12) or higher than 13.5Gy (n=7). The conditioning regimens based on chemotherapy included busulfan and cyclophosphamide±other chemotherapeutic (CTx) agents (n=84), cyclophosphamide+other CTx agents (n=62), fludarabine+other CTx agents (n=46) and etoposide+other CTx agents (n=26).Seven patients did not receive any conditioning treatment. Fifty-eight patients had received radiotherapy (RT) before HSCT as treatment for their malignant disease. The RT dose generally ranged from 12.5Gy to 20Gy (n=47) and exceeded 20Gy in 11 patients.Graft-versus-host disease (GvHD) prophylaxis was based mainly on cyclosporine, alone (n=88) or in association with other immunosuppressant drugs, such as methotrexate±mycophenolate (n=70), prednisone (n=18) or mycophenolate (n=18). In vivo T-cell depletion was performed in 56 HSCTs by means of antithymocyte thymoglobulin (ATG) or alemtuzumab (Campath).DefinitionsWe defined event as any adverse occurrence after the transplant: disease relapse, secondary malignancy, or death.We defined overall survival as survival from the time of transplantation, and event-free survival as duration of survival from the time of transplantation with no evidence of any event. We defined transplant-related mortality as death from any cause related to transplantation with the exception of the underlying disease.Statistical analysisWe used the log-rank test to analyse potential risk factors. We performed the univariate analysis by constructing contingency tables and applying the inferential chi square test. We performed the multivariate analysis by developing a logistic regression model, calculating the odds ratios for each factor. The statistical significance level was fixed at the usual 5% (α=0.05). All the analyses were performed with the statistical package IBM-SPSS (Statistical Package for Social Sciences) version 22.0 for Windows.ResultsWe observed 19 cases of SMN in the cohort (5.1%). The cumulative incidence was 6% at 15 years, 12% at 20 years and 36% at 30 years of follow-up (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The median age of patients at diagnosis of the SMN was 25 years (11–42 years). The median duration of the latency period between HSCT and diagnosis of the SMN was 16 years (1–31 years) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>In our series, solid tumours were the most prevalent malignancies, amounting to 84% of cases (n=16). The median latency period for solid tumours was 18.5 years (7–28 years). The secondary solid tumour was the cause of death in 5 patients. Skin cancers were the most frequent type of solid tumour (n=5), followed by carcinomas of the thyroid (n=3), gynaecological cancers (n=3) and sarcomas (n=3). There was one case of brain tumour and one case of colon cancer. Blood tumours amounted to 16% of the cases in our series (n=3): 2 cases of acute myeloblastic leukaemia (AML) and 1 case of post-transplant lymphoproliferative disorder (PTLD). All three patients died of the secondary malignancy. The latency period was shorter compared to solid tumours: less than 1 year for 2 of the patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The indication for transplantation in almost every patient that developed a SMN (17 out of 19 patients) was a malignancy: acute leukaemia in 12 patients and a solid tumour in 5 patients. The non-malignant disorders that indicated HSCT were Fanconi anaemia and aplastic anaemia.Eleven patients underwent autologous transplantation and 8 patients allogeneic transplantation.<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> summarizes the characteristics of the patients, the HSCTs and the SMNs.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>In this cohort, 17 out of 19 patients had received irradiation. During the conditioning, 12 patients received TBI (12.5Gy) and 2 patients thoracoabdominal irradiation (5Gy). Two patients that received TBI-based conditioning had also been treated with radiotherapy before: 1 patient received whole brain radiotherapy (19Gy) and 1 patient thoracic irradiation (>20Gy). Three patients received radiotherapy only for treatment of the underlying disease, but not during conditioning: 1 patient whole brain radiotherapy (19Gy), 1 abdominal irradiation (20Gy) and 1 thoracic irradiation (20Gy). The patients that received whole brain radiotherapy developed the late malignancy at a cranial site: 1 osteosarcoma of the skullcap, and 1 high-grade brain glioma. The secondary malignancy was the cause of death in both cases.The mortality in patients that developed a SMN was 47.4% (n=9). In all patients that died, the cause was the secondary malignancy.In the univariate analysis, TBI-based conditioning was associated with an increased risk of SMN, although the association was not statistically significant (OR=2.73; P=.05). Previous RT was associated with a 3-fold increase in risk that was statistically significant (OR=.1; P=.04). Chronic GvHD was significantly associated with an increased risk of malignancy (OR=16; P=.006) (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 3</a>).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>In the multivariate analysis, TBI and chronic GvHD were the factors significantly associated with an increased risk of malignancy. TBI increased the risk by four (OR=4.3; P=.03) and chronic GVHD by more than fifteen (OR=15.4; P<.0001). Previous RT was not associated with an increase in risk in the multivariate analysis (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 4</a>).<elsevierMultimedia ident="tbl0025"></elsevierMultimedia>In our series, acute GvHD was not associated with an increased risk of SMN. We analysed other factors such as the type of HSCT, the type of underlying disease, age at HSCT, and in vivo depletion of T-lymphocytes, but none of them was associated with an increase in risk.To verify that malignancies in our cohort were more frequent compared to general population, we compared the incidence in our cohort with the expected incidence in the general population for each age group. The limited number of cases in our study did not allow us to perform a statistical analysis that strictly fulfilled the conditions required for the application of the test. Nevertheless, we confirmed that the incidence was much higher than expected in our cohort, for each malignancy and in male as well as female patients, and that the difference was statistically significant (P<.0001).We obtained the population data we used for this analysis from the Spanish Cancer Registries Network (Registre de Càncer de Tarragona, Fundació Lliga per a la Investigació i Prevenció del Càncer).DiscussionSeveral studies have reported that survivors of HSCT have an increased risk of secondary malignant neoplasms, which are an important cause of late mortality.The cumulative incidence in our study (6%, 12%, and 36% at 15, 20, and 30 years, respectively) confirms that the risk of SMN increases with time. Interestingly, although our data come from a single-centre cohort, the proportions we observed are among the highest of those published. For solid tumours, the reported incidence in the largest series in the literature (for more than 19000 patients) is 1%–6% at 10 years and 2%–15% at 15 years.<a class="elsevierStyleCrossRef" href="#bib0085">1</a> The study published by the researchers of the Center for International Blood and Marrow Transplant Research (CIBMTR) and the Fred Hutchinson Cancer Research Center (FHCRC) reported 189 cases of secondary solid malignancies in a cohort of 28874 allogeneic HSCT recipients (adults and children).<a class="elsevierStyleCrossRef" href="#bib0095">3</a> The cumulative incidence was 1% at 10 years, 2.2% at 15 years and 3.3% at 20 years after HSCT. A European study with a cohort of 1036 patients found a cumulative incidence of solid tumours of 3.5% at 10 years and 12.8% at 15 years.<a class="elsevierStyleCrossRef" href="#bib0100">4</a>In our case series, the most frequent secondary solid tumours were of the thyroid, skin and breast.Thyroid cancer is a typical radio-induced malignancy that is observed mainly in previously irradiated patients.<a class="elsevierStyleCrossRefs" href="#bib0105">5,6</a> However, it has also been described as a secondary tumour after HSCT in patients that have never received irradiation, which suggests that other mechanisms may be at play in the development of these tumours.<a class="elsevierStyleCrossRef" href="#bib0115">7</a> Consistent with these findings, we also found a case of papillary carcinoma in a patient with no history of irradiation.The association between radiotherapy and an increased risk of basal cell carcinoma (BCC) is well known. Indeed, the basal membrane of epidermis, where 70% of proliferative cells are located, is the most radiosensitive part of the skin.<a class="elsevierStyleCrossRef" href="#bib0120">8</a> A Japanese study of survivors of the atomic bomb underscored that survivors were at increased risk of BCC compared to individuals who had not been exposed to ionizing radiation, with a relative risk of 1.8% (90% CI, 0.8–.3), and that this risk increased with time.<a class="elsevierStyleCrossRef" href="#bib0125">9</a> Skin cancers (non-melanoma type) typically develop in old age, with a median age of onset of 64 years.<a class="elsevierStyleCrossRef" href="#bib0130">10</a> Survivors of HSCT, however, develop skin malignancies at a younger age compared to the general population, usually by 30 years of age, as demonstrated by Perkins et al.<a class="elsevierStyleCrossRef" href="#bib0130">10</a> In our cohort, the 3 patients that developed basal cell carcinomas were aged 23, 27, and 34 years, which confirmed the comparatively earlier onset.We found two cases of breast cancer that developed before age 30 years. Early age at transplantation and TBI-based conditioning have been described as the main risk factors in the literature. A collaborative study of the FHCRC and the EBMT published in 2008 evaluated the incidence of secondary breast cancer in survivors of allogeneic HSCT.<a class="elsevierStyleCrossRef" href="#bib0135">11</a> This study found 52 cases of cancer in its cohort of 3337 women (1026 of whom had undergone transplant at a paediatric age). The cumulative incidence increased with time: 0.8% at 10 years, 4.6% at 20 years, and 11% at 25 years from HSCT.In the literature, secondary AML is related to high-dose chemotherapy and autologous HSCT; development of leukaemia from donor cells in survivors of allogeneic HSCTs is extremely rare.<a class="elsevierStyleCrossRef" href="#bib0140">12</a> A study in lymphoma patients with a minimum duration of follow-up of 5 years found a risk for developing AML after autologous HSCT of 3%–19.8%.<a class="elsevierStyleCrossRef" href="#bib0145">13</a> Similarly, the 2 patients that developed AML in our cohort had undergone an autologous HSCT with a TBI-based conditioning regimen.When it comes to PTLD, the reported incidence in large-scale series is very low (1%–1.6%), and it is generally associated with a poor prognosis.<a class="elsevierStyleCrossRef" href="#bib0150">14</a> Two main risk factors have been identified: intensive immunosuppression, and, in many cases, Epstein–Barr virus (EBV) reactivation.<a class="elsevierStyleCrossRef" href="#bib0155">15</a> In the patient in our cohort, PTLD was associated with EBV reactivation.One of the objectives of our study was to highlight the risk factors associated with developing a secondary malignancy. Our study corroborated that radiotherapy is one of the main risk factors for SMNs. Interestingly, chronic GvHD was also a major risk factor for SMNs (RR=15.4). In the literature, chronic GvHD has been associated with an increased risk of squamous cutaneous malignancies, mainly in the oral cavity and skin. Some series suggest that immunosuppressive therapy for management of chronic GVHD (such as cyclosporine or azathioprine) is a risk factor for SMNs.<a class="elsevierStyleCrossRef" href="#bib0160">16</a> Chronic inflammation and long-term immunosuppressive therapy can interfere with tissue repair, increasing the risk of developing tumours.Our results corroborate the role played by irradiation in the development of SMN. Total body irradiation (associated with cyclophosphamide) has been the gold standard for conditioning before HSCT for many years. The shift towards less toxic regimens without irradiation in the last decade may have the benefit of reducing the incidence of late complications such as SMN. We need more time of follow-up to analyse the impact of these novel reduced-intensity conditioning regimens on the development of secondary tumours. Another important aspect corroborated by our data is that chronic GvHD is a complication that seems to carry an increased risk of SMN. Chronic GvHD prophylaxis thus appears to be the best available strategy to prevent late malignancies. However, its use must be carefully weighed against the associated increase in disease relapse in patients in whom HSCT was performed to treat malignant disease.The high incidence of late malignancies highlights the need for life-long surveillance of HSCT survivors.One of the main strengths of our study was the long duration of follow-up, as the incidence of secondary malignancies tends to increase with time, and it allowed us to report several cases of SMN despite the small size of the study cohort. In addition, there were no losses to follow-up, so we were able to report the actual incidence of SMNs. There are also limitations to our study. Despite the high number of SMNs we observed, the small size of our cohort did not allow us to reach generalizable conclusions. The heterogeneity in chemotherapy treatments for solid tumours and leukaemia prevented us from analysing the impact of these previous treatments on the risk of secondary malignancies. Lastly, we did not study the possible role in oncogenesis of other exogenous factors (alcohol, tobacco, obesity, hormonal treatment, etc.) or genetic factors.In conclusion, subsequent malignant neoplasms constitute an important cause of morbidity and mortality in long-term survivors of hematopoietic stem cell transplantation. We have observed a very high incidence of SMNs in patients that underwent HSCT in the paediatric age. Radiotherapy and chronic GvHD were the main risk factors associated with the development of SMN in our study.Conflicts of interestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1157862" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1085016" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1157863" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1085015" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Definitions" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical analysis" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 11 => array:2 [ "identificador" => "xack395067" "titulo" => "Acknowledgments" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-03-07" "fechaAceptado" => "2018-05-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1085016" "palabras" => array:4 [ 0 => "Hematopoietic stem cell transplantation" 1 => "Subsequent malignant neoplasms" 2 => "Radiotherapy" 3 => "Chronic graft versus host disease" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1085015" "palabras" => array:4 [ 0 => "Trasplante hematopoyético" 1 => "Neoplasias malignas secundarias" 2 => "Radioterapia" 3 => "Enfermedad de injerto contra el huésped crónica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionSurvival after hematopoietic stem cell transplantation has improved dramatically in recent years. Unfortunately, there is an increased risk of subsequent malignant neoplasms (SMN) in this population and this represents a significant cause of late mortality. Patients and methodsIn this study, we analysed the incidence of SMN and the associated risk factors in patients referred at a paediatric age for hematopoietic stem cell transplantation (allogeneic or autologous) in our centre. ResultsWe observed 19 cases of SMN in a cohort of 371 patients, with a cumulative incidence of 6, 12, and 36% at 15, 20, and 30 years of follow-up, respectively. The solid tumours were the most prevalent malignancies. The risk was significantly higher than expected in the general population for each tumour type and in the different age ranges (P<.0001). Radiotherapy and chronic GvHD were the main risk factors for the development of SMN in our series. ConclusionsWe observed a high incidence of SMN among hematopoietic stem cell transplantation survivors highlighting the need for life-long surveillance." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa supervivencia después del trasplante de progenitores hematopoyéticos ha mejorado de forma importante en los últimos años. Desafortunadamente, se ha descrito un mayor riesgo de neoplasias malignas secundarias (NMS) en esta población representando una causa importante de mortalidad tardía. Pacientes y métodosEn este estudio, analizamos la incidencia de NMS y los factores de riesgo asociados en los pacientes sometidos en edad pediátrica a un trasplante de progenitores hematopoyéticos (alogénico o autólogo) en nuestro centro. ResultadosObservamos 19 casos de NMS en una cohorte de 371 pacientes, siendo la incidencia acumulada del 6, 12 y 36% a los 15, 20 y 30 años de seguimiento, respectivamente. Los tumores sólidos fueron los más prevalentes. El riesgo fue significativamente mayor de lo esperado en la población general para cada tipo de tumor y en los diferentes rangos de edad (p<0,0001). La radioterapia y la EICH crónica fueron los principales factores de riesgo para el desarrollo de NMS en nuestra serie. ConclusionesHemos observado una alta incidencia de neoplasias malignas secundarias en los supervivientes de un trasplante de progenitores hematopoyéticos evidenciando la necesidad de un seguimiento a largo plazo de esta población de pacientes." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Sisinni L, Gich I, Torrent M, Badell I. Neoplasias malignas secundarias después de un trasplante de progenitores hematopoyéticos en edad pediátrica. An Pediatr (Barc). 2019;90:157–164." ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1010 "Ancho" => 1520 "Tamanyo" => 76410 ] ] "descripcion" => array:1 [ "en" => "Cumulative incidence of SMNs." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1166 "Ancho" => 2202 "Tamanyo" => 110816 ] ] "descripcion" => array:1 [ "en" => "Latency period until onset of SMN." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of neoplasm \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N (=19) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Status \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Skin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="4" align="char" valign="top">5</td><td class="td" title="table-entry " align="left" valign="top">Alive (4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Basal cell (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Dead (1)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Squamous (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Melanoma (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Thyroid cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Alive (3)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Papillary (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Follicular (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gynaecological \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Alive (3)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Breast carcinoma (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Uterus PNET (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sarcoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Dead (3)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Osteosarcoma (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Angiosarcoma (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood tumour \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Dead (3)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">AML (2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PTLD (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cerebral glioma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " rowspan="2" align="char" valign="top">1</td><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Dead</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">(Glioblastoma multiforme) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Colon cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977031.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Types of subsequent malignant neoplasms." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "CARBO: carboplatin; MEL: melphalan; Cy: cyclophosphamide; TBI: total body irradiation; CsA: cyclosporine A; MTX: methotrexate; MMF: mycophenolate mofetil; BM: bone marrow; PB: peripheral blood; UCB: umbilical cord blood; SD: sibling donor; MUD: matched unrelated donor; TT: thiotepa; TAI: thoracoabdominal irradiation." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pt \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex/age at HCST (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Disease \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HSCT type/source \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Conditioning/GvHD prophylaxis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Previous radiotherapy (dose) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">GvHD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Secondary malignancy (type) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at malignancy (years) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vital status \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cause of death \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Solid tumour (Wilms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CARBO-VP16-MEL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (whole brain) (12.5–20Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Skull cap osteosarcoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-SD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy)/CsA+MTX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (whole brain) (12.5–20Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cerebral glioma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-SD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy)/CsA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (acute II; chronic: skin/extensive) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Uterus (PNET) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-SD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy)/CsA+MTX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (acute I; chronic: skin/extensive) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Breast cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-SD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy)/CsA+MTX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Basal cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Basal cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Solid tumour (neuroblastoma) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy+other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (abdomen) (12.5–20Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Osteosarcoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-MUD/PB Allo-MUD/CB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">BU-Cy/CsA+MMF FLU+other/CsA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PTLD×EBV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Colon adenocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AML \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Basal cell cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-SD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy)/CsA+MTX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Breast cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Fanconi A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-SD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TAI (<10Gy)/CsA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Skin squamous cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hodgkin lymphoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">VP16+MEL+TT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (thoracic) (12.5–20Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Papillary thyroid cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">B-ALL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-VP16-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Melanoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aplastic anaemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Allo-MUD/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TAI (<10Gy)-ATG/CsA+MTX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (acute I) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatic angiosarcoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Dead \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SMN \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-Hodgkin lymphoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy-TBI (12.5Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes (thoracic) (>20Gy) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Follicular thyroid cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Solid tumour (Wilms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Auto/BM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cy+other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Papillary thyroid cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Alive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977033.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Patient and HSCT characteristics." ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "TBI: total body irradiation; RT: radiotherapy; GvHD: graft-versus-host disease; OR: odds ratio; 95% CI: 95% confidential interval for odds ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Factor \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TBI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.0–8.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.0–9.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TBI+RT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.5–9.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at HSCT ≥10y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.7–4.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at HSCT <10y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.2–1.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute GvHD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1–1.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic GvHD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.8–98.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Malignant disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3–6.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nonmalignant disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1–2.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Auto-HSCT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3–2.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Allo-HSCT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.4–2.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">In vivo T-cell depletion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.1–4.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977030.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Risk factors for subsequent malignancies (univariate analysis)." ] ] 5 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "TBI: total body irradiation; RT: radiotherapy; GvHD: graft-versus-host disease; OR: odds ratio; 95% CI: 95% confidential interval for odds ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Factor \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TBI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at HSCT ≥10y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute GvHD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic GvHD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977032.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Risk factors for subsequent malignancies (multivariate analysis)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0085" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Solid cancers after bone marrow transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.E. Curtis" 1 => "P.A. Rowlings" 2 => "H.J. Deeg" 3 => "A.S. Donna" 4 => "G. Socié" 5 => "L.B. Travis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199703273361301" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1997" "volumen" => "336" "paginaInicial" => "897" "paginaFinal" => "904" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9070469" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0090" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New malignant diseases after allogeneic marrow transplantation for childhood acute leukemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Socié" 1 => "R.E. Curtis" 2 => "H.J. Deeg" 3 => "K.A. Sobocinski" 4 => "M. Arora" 5 => "M.M. Horowitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2000.18.2.348" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2000" "volumen" => "18" "paginaInicial" => "348" "paginaFinal" => "357" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10637249" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0095" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Solid cancers after allogeneic hematopoietic cell transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.D. Rizzo" 1 => "R.E. Curtis" 2 => "G. Socié" 3 => "A. Kathleen" 4 => "K.A. Sobocinski" 5 => "E. Gilbert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2008-05-158782" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2009" "volumen" => "113" "paginaInicial" => "1175" "paginaFinal" => "1183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18971419" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0100" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malignant neoplasms in long-term survivors of bone marrow transplantation. Late Effects Working Party of the European Cooperative Group for Blood and Marrow Transplantation and the European Late Effects Project Group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.J. Kolb" 1 => "G. Socié" 2 => "T. Duell" 3 => "M.T. van Lint" 4 => "A. Tichelli" 5 => "J.F. Apperley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1999" "volumen" => "131" "paginaInicial" => "738" "paginaFinal" => "744" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10577296" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673605711417" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0105" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Acharya" 1 => "K. Sarafoglou" 2 => "M. LaQuaglia" 3 => "S. Lindsley" 4 => "W. Gerald" 5 => "N. Wollner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.11362" "Revista" => array:5 [ "tituloSerie" => "Cancer" "fecha" => "2003" "volumen" => "97" "paginaInicial" => "2397" "paginaFinal" => "2403" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0110" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk of thyroid cancer in survivors of childhood cancer: results from the British Childhood Cancer Survivor Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.J. Taylor" 1 => "A.P. Croft" 2 => "A.M. Palace" 3 => "D.L. Winter" 4 => "R.C. Reulen" 5 => "C.A. Stiller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ijc.24581" "Revista" => array:6 [ "tituloSerie" => "Int J Cancer" "fecha" => "2009" "volumen" => "125" "paginaInicial" => "2400" "paginaFinal" => "2405" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19610069" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0115" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk for secondary thyroid carcinoma after hematopoietic stemcell transplantation: an EBMT Late Effects Working Party Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Cohen" 1 => "A. Rovelli" 2 => "D.F. Merlo" 3 => "M.T. van Lint" 4 => "E. Lanino" 5 => "D. Bresters" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO. 9276 200608" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2007" "volumen" => "25" "paginaInicial" => "2449" "paginaFinal" => "2454" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17557958" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0120" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "DNA Damage, apoptosis and langerhans cells – activators of UV-induced immune tolerance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Timares" 1 => "S. Katiyar" 2 => "C.A. Elmets" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1751-1097.2007.00284.x" "Revista" => array:7 [ "tituloSerie" => "Photochem Photobiol" "fecha" => "2008" "volumen" => "84" "paginaInicial" => "422" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18248501" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109715042709" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0125" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Skin tumor risk among atomic-bomb survivors in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Ron" 1 => "D.L. Preston" 2 => "M. Kishikawa" 3 => "T. Kobuke" 4 => "M. Iseki" 5 => "S. Tokuoka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer Causes Control" "fecha" => "1998" "volumen" => "9" "paginaInicial" => "393" "paginaFinal" => "401" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9794171" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0130" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonmelanoma skin cancer in survivors of childhood and adolescent cancer: a report from the childhood cancer survivor study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Perkins" 1 => "Y. Liu" 2 => "P.A. Mitby" 3 => "J.P. Neglia" 4 => "S. Hammond" 5 => "M. Stovall" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO. 237 200506" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2005" "volumen" => "23" "paginaInicial" => "3733" "paginaFinal" => "3741" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15923570" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0135" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased risk of breast cancer among survivors of allogeneic hematopoietic cell transplantation: a report from the FHCRC and the EBMT-Late Effect Working Party" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.L. Friedman" 1 => "A. Rovo" 2 => "W. Leisenring" 3 => "A. Locasciulli" 4 => "M. Flowers" 5 => "A. Tichelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2007-07-099283" "Revista" => array:7 [ "tituloSerie" => "Blood" "fecha" => "2008" "volumen" => "111" "paginaInicial" => "939" "paginaFinal" => "944" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17911386" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109713050924" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0140" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Donor cell leukemia: insight into cancer stem cells and the stem cell niche" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.M. Flynn" 1 => "D.S. Kaufman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2006-07-021980" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2007" "volumen" => "109" "paginaInicial" => "2688" "paginaFinal" => "2692" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17132724" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0145" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Therapy-related acute myeloid leukemia and myelodysplasia after high-dose chemotherapy and autologous stem cell transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Pedersen-Bjergaard" 1 => "M.K. Andersen" 2 => "D.H. Christiansen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2000" "volumen" => "95" "paginaInicial" => "3273" "paginaFinal" => "3279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10828005" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0150" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.E. Curtis" 1 => "L.B. Travis" 2 => "P.A. Rowlings" 3 => "G. Socié" 4 => "D.W. Kingma" 5 => "P.M. Banks" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Blood" "fecha" => "1999" "volumen" => "94" "paginaInicial" => "2208" "paginaFinal" => "2216" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0155" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "B cell lymphoproliferative disorders following hematopoietic stem cell transplantation: risk factors, treatment and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.G. Gross" 1 => "M. Steinbuch" 2 => "T. DeFor" 3 => "R.S. Shapiro" 4 => "P. McGlave" 5 => "N.K. Ramsay" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.bmt.1701554" "Revista" => array:6 [ "tituloSerie" => "Bone Marrow Transplant" "fecha" => "1999" "volumen" => "23" "paginaInicial" => "251" "paginaFinal" => "258" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10084256" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0160" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of chronic GVHD therapy on the development of squamous-cell cancers after hematopoietic stem-cell transplantation: an international case-control study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.E. Curtis" 1 => "C. Metayer" 2 => "J.D. Rizzo" 3 => "G. Socié" 4 => "K.A. Sobocinski" 5 => "M.E. Flowers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2004-09-3411" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2005" "volumen" => "105" "paginaInicial" => "3802" "paginaFinal" => "3811" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15687239" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack395067" "titulo" => "Acknowledgments" "texto" => "We want to thank Jaume Galceran, head of the Spanish Cancer Registries Network, Registre de Càncer de Tarragona, Fundació Lliga per a la Investigació i Prevenció del Càncer, Reus (Tarragona, Spain)." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009000000003/v1_201903020636/S2341287918301686/v1_201903020636/en/main.assets" "Apartado" => array:4 [ "identificador" => "26005" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009000000003/v1_201903020636/S2341287918301686/v1_201903020636/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287918301686?idApp=UINPBA00005H"]

Statistics

Original Article

Subsequent malignancies after long-term follow-up of paediatric hematopoietic stem cell transplantation

Neoplasias malignas secundarias después de un trasplante de progenitores hematopoyéticos en edad pediátrica

Luisa Sisinnia,

Corresponding author

lsisinni@santpau.cat

Corresponding author.

, Ignasi Gichb, Montserrat Torrenta, Isabel Badella

a Pediatric Hematology, Oncology and HSCT Unit, Santa Creu i Sant Pau University Hospital, Barcelona, Spain

b Clinical Epidemiology Department, Santa Creu i Sant Pau University Hospital, Barcelona, Spain

Read

4596

Times
was read the article

2152

Total PDF

2444

Total HTML

Share statistics

 array:25 [
  "pii" => "S2341287918301686"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2018.10.002"
  "estado" => "S300"
  "fechaPublicacion" => "2019-03-01"
  "aid" => "2500"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2019;90:157-64"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 910
    "formatos" => array:3 [
      "EPUB" => 102
      "HTML" => 557
      "PDF" => 251
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S1695403318303187"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2018.05.023"
      "estado" => "S300"
      "fechaPublicacion" => "2019-03-01"
      "aid" => "2500"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2019;90:157-64"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2518
        "formatos" => array:3 [
          "EPUB" => 190
          "HTML" => 1708
          "PDF" => 620
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
        "titulo" => "Neoplasias malignas secundarias despu&#233;s de un trasplante de progenitores hematopoy&#233;ticos en edad pedi&#225;trica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "157"
            "paginaFinal" => "164"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Subsequent malignancies after long-term follow-up of pediatric hematopoietic stem cell transplantation"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1010
                "Ancho" => 1520
                "Tamanyo" => 76795
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Incidencia acumulada de NMS&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Luisa Sisinni, Ignasi Gich, Monserrat Torrent, Isabel Badell"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Luisa"
                "apellidos" => "Sisinni"
              ]
              1 => array:2 [
                "nombre" => "Ignasi"
                "apellidos" => "Gich"
              ]
              2 => array:2 [
                "nombre" => "Monserrat"
                "apellidos" => "Torrent"
              ]
              3 => array:2 [
                "nombre" => "Isabel"
                "apellidos" => "Badell"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287918301686"
          "doi" => "10.1016/j.anpede.2018.10.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287918301686?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318303187?idApp=UINPBA00005H"
      "url" => "/16954033/0000009000000003/v2_202009040640/S1695403318303187/v2_202009040640/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2341287919300055"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2018.03.011"
    "estado" => "S300"
    "fechaPublicacion" => "2019-03-01"
    "aid" => "2433"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2019;90:165-72"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1215
      "formatos" => array:3 [
        "EPUB" => 88
        "HTML" => 842
        "PDF" => 285
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Consumption of free sugars and excess weight in infants&#46; A longitudinal study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "165"
          "paginaFinal" => "172"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Ingesta de az&#250;cares libres y exceso de peso en edades tempranas&#46; Estudio longitudinal"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1839
              "Ancho" => 2344
              "Tamanyo" => 191691
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Percentage of total energy contributed by free sugars &#40;FSs&#41; and natural sugars at age 12 months by weight status at age 30 months&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Cristina Jard&#237;, N&#250;ria Aranda, Cristina Bedmar, Blanca Ribot, Irene Elias, Estefania Aparicio, Victoria Arija"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Jard&#237;"
            ]
            1 => array:2 [
              "nombre" => "N&#250;ria"
              "apellidos" => "Aranda"
            ]
            2 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Bedmar"
            ]
            3 => array:2 [
              "nombre" => "Blanca"
              "apellidos" => "Ribot"
            ]
            4 => array:2 [
              "nombre" => "Irene"
              "apellidos" => "Elias"
            ]
            5 => array:2 [
              "nombre" => "Estefania"
              "apellidos" => "Aparicio"
            ]
            6 => array:2 [
              "nombre" => "Victoria"
              "apellidos" => "Arija"
            ]
            7 => array:1 [
              "colaborador" => "Grupo investigador DeFensas"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S169540331830153X"
        "doi" => "10.1016/j.anpedi.2018.03.018"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540331830153X?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300055?idApp=UINPBA00005H"
    "url" => "/23412879/0000009000000003/v1_201903020636/S2341287919300055/v1_201903020636/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2341287918301431"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2018.05.003"
    "estado" => "S300"
    "fechaPublicacion" => "2019-03-01"
    "aid" => "2486"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2019;90:148-56"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2955
      "formatos" => array:3 [
        "EPUB" => 126
        "HTML" => 2441
        "PDF" => 388
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Real-world effectiveness of ivacaftor in children with cystic fibrosis and the G551D mutation"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "148"
          "paginaFinal" => "156"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Efectividad de ivacaftor en vida real en ni&#241;os con fibrosis qu&#237;stica y mutaci&#243;n G551D"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "David Gomez-Pastrana, Chinedu Nwokoro, Mike McLean, Sarah Brown, Nanna Christiansen, Caroline S&#46; Pao"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "David"
              "apellidos" => "Gomez-Pastrana"
            ]
            1 => array:2 [
              "nombre" => "Chinedu"
              "apellidos" => "Nwokoro"
            ]
            2 => array:2 [
              "nombre" => "Mike"
              "apellidos" => "McLean"
            ]
            3 => array:2 [
              "nombre" => "Sarah"
              "apellidos" => "Brown"
            ]
            4 => array:2 [
              "nombre" => "Nanna"
              "apellidos" => "Christiansen"
            ]
            5 => array:2 [
              "nombre" => "Caroline S&#46;"
              "apellidos" => "Pao"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403318303047"
        "doi" => "10.1016/j.anpedi.2018.05.022"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318303047?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287918301431?idApp=UINPBA00005H"
    "url" => "/23412879/0000009000000003/v1_201903020636/S2341287918301431/v1_201903020636/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Subsequent malignancies after long-term follow-up of paediatric hematopoietic stem cell transplantation"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "157"
        "paginaFinal" => "164"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Luisa Sisinni, Ignasi Gich, Montserrat Torrent, Isabel Badell"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Luisa"
            "apellidos" => "Sisinni"
            "email" => array:1 [
              0 => "lsisinni&#64;santpau&#46;cat"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ignasi"
            "apellidos" => "Gich"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Montserrat"
            "apellidos" => "Torrent"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Isabel"
            "apellidos" => "Badell"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Pediatric Hematology&#44; Oncology and HSCT Unit&#44; Santa Creu i Sant Pau University Hospital&#44; Barcelona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Clinical Epidemiology Department&#44; Santa Creu i Sant Pau University Hospital&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Neoplasias malignas secundarias despu&#233;s de un trasplante de progenitores hematopoy&#233;ticos en edad pedi&#225;trica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1010
            "Ancho" => 1520
            "Tamanyo" => 76410
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cumulative incidence of SMNs&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Hematopoietic stem cell transplantation &#40;HSCT&#41; can cure several malignant and nonmalignant diseases&#44; congenital and acquired&#44; in paediatric and adult patients&#46; In recent years&#44; advances in the procedure and in associated supportive therapies have resulted in an increase in long-term survival&#46; Unfortunately&#44; an increased risk of subsequent malignant neoplasms &#40;SMN&#41; has also been described in this group of patients&#46; There are few reports in which the studied population is exclusively paediatric&#46; The studies of Curtis et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> in 1997 and the study of Soci&#233; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> in 2000 reported that the risk of SMN was 36-fold and 45-fold&#44; respectively&#44; in children that had undergone HSCT&#46; Both studies found an inverse correlation between the risk of a late malignancy and age&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In our study&#44; we analysed the incidence of SMN in patients that underwent HSCT in our paediatric unit and the associated risk factors&#46; Analysing the risk factors related to the development of these malignancies is crucial for the purpose of improving the conditioning regimens and supportive therapies associated with HSCT&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">The cohort under study comprised 371 patients that underwent HSCT &#40;autologous or allogeneic&#41; between 1984 and 2013 at the Paediatric HSCT Unit of our hospital&#46; We analysed a total of 434 transplants&#44; which amounted to all the HSCTs performed in our unit between 1984 and 2013&#46; There were no losses to follow-up&#46; Of the 371 patients&#44; 63 received more than one transplant&#58; 2 HSCTs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58&#41; or 3 HSCTs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#46; We obtained the informed consent of the legal guardians for the HSCT procedure and subsequent studies&#46; We collected data on patient characteristics&#44; HSCT type&#44; and clinical outcomes prospectively in a database designed for the purpose&#46; We finished collecting outcome data on September 30&#44; 2016&#46; The duration of follow-up was 30 years&#46; We contacted all adult patients discharged from follow-up at our hospital to obtain information about their current vital status and complications such as malignancies&#46; All the secondary malignancies had been diagnosed in our hospital&#44; so we were able to review the pertinent diagnostic test and patient health records&#46; The median age of the patients at the time of transplantation was 8&#46;4 years &#40;0&#46;1&#8211;20 years&#41;&#44; and 9 patients were aged more than 18 years&#46; Of all patients&#44; 226 &#40;60&#46;9&#37;&#41; were male and 145 &#40;39&#46;1&#37;&#41; female&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The indication for HSCT was a malignant disease in 317 patients &#40;85&#46;4&#37;&#41; and a nonmalignant disease in 54 patients &#40;14&#46;6&#37;&#41;&#46; The malignant diseases included blood tumours &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>209&#41; and solid tumours &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>108&#41;&#46; The nonmalignant diseases included primary immunodeficiencies &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; aplastic anaemias &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41;&#44; congenital bone marrow failures &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#44; hemoglobinopathies &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; and metabolic diseases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&#46; The disease status at the time of transplantations in patients with malignant disease was first complete remission in 146 patients&#44; second complete remission in 101 patients and advanced stage or refractory disease in 7 patients&#46; The HSCT was autologous in 234 cases &#40;53&#46;9&#37;&#41; and allogeneic in 200 cases &#40;46&#46;1&#37;&#41;&#46; The donor was a related donor in 141 cases &#40;32&#46;5&#37;&#41; and an unrelated donor in 59 cases &#40;13&#46;6&#37;&#41;&#46; As for HLA compatibility&#44; the donor of allogeneic transplants was a matched sibling donor in 106 cases&#44; a haploidentical donor in 35 cases&#44; a matched unrelated donor in 23 cases&#44; and a mismatched unrelated donor in 36 cases&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The most frequent source of hematopoietic stem cells was bone marrow &#40;68&#46;7&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>298&#41; followed by mobilized peripheral blood &#40;23&#46;7&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>103&#41; and umbilical cord blood &#40;5&#46;8&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&#46; A combination of different sources &#40;cord blood plus bone marrow or peripheral blood&#41; was used in 8 transplants&#46; The conditioning regimen was based on total body irradiation &#40;TBI&#41; in 48&#46;2&#37; of the HSCTs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>209&#41;&#46; The fractionated irradiation dose ranged between 10 and 13&#46;5<span class="elsevierStyleHsp" style=""></span>Gy in most cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>190&#41;&#46; Few patients received a dose lower than 10<span class="elsevierStyleHsp" style=""></span>Gy &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; or higher than 13&#46;5<span class="elsevierStyleHsp" style=""></span>Gy &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&#46; The conditioning regimens based on chemotherapy included busulfan and cyclophosphamide<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>other chemotherapeutic &#40;CTx&#41; agents &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>84&#41;&#44; cyclophosphamide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>other CTx agents &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62&#41;&#44; fludarabine<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>other CTx agents &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41; and etoposide<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>other CTx agents &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Seven patients did not receive any conditioning treatment&#46; Fifty-eight patients had received radiotherapy &#40;RT&#41; before HSCT as treatment for their malignant disease&#46; The RT dose generally ranged from 12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy to 20<span class="elsevierStyleHsp" style=""></span>Gy &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>47&#41; and exceeded 20<span class="elsevierStyleHsp" style=""></span>Gy in 11 patients&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Graft-versus-host disease &#40;GvHD&#41; prophylaxis was based mainly on cyclosporine&#44; alone &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>88&#41; or in association with other immunosuppressant drugs&#44; such as methotrexate<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>mycophenolate &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>70&#41;&#44; prednisone &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41; or mycophenolate &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&#46; In vivo T-cell depletion was performed in 56 HSCTs by means of antithymocyte thymoglobulin &#40;ATG&#41; or alemtuzumab &#40;Campath&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Definitions</span><p id="par0040" class="elsevierStylePara elsevierViewall">We defined event as any adverse occurrence after the transplant&#58; disease relapse&#44; secondary malignancy&#44; or death&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We defined overall survival as survival from the time of transplantation&#44; and event-free survival as duration of survival from the time of transplantation with no evidence of any event&#46; We defined transplant-related mortality as death from any cause related to transplantation with the exception of the underlying disease&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">We used the log-rank test to analyse potential risk factors&#46; We performed the univariate analysis by constructing contingency tables and applying the inferential chi square test&#46; We performed the multivariate analysis by developing a logistic regression model&#44; calculating the odds ratios for each factor&#46; The statistical significance level was fixed at the usual 5&#37; &#40;<span class="elsevierStyleItalic">&#945;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; All the analyses were performed with the statistical package IBM-SPSS &#40;Statistical Package for Social Sciences&#41; version 22&#46;0 for Windows&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">We observed 19 cases of SMN in the cohort &#40;5&#46;1&#37;&#41;&#46; The cumulative incidence was 6&#37; at 15 years&#44; 12&#37; at 20 years and 36&#37; at 30 years of follow-up &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The median age of patients at diagnosis of the SMN was 25 years &#40;11&#8211;42 years&#41;&#46; The median duration of the latency period between HSCT and diagnosis of the SMN was 16 years &#40;1&#8211;31 years&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">In our series&#44; solid tumours were the most prevalent malignancies&#44; amounting to 84&#37; of cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#41;&#46; The median latency period for solid tumours was 18&#46;5 years &#40;7&#8211;28 years&#41;&#46; The secondary solid tumour was the cause of death in 5 patients&#46; Skin cancers were the most frequent type of solid tumour &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#44; followed by carcinomas of the thyroid &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#44; gynaecological cancers &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41; and sarcomas &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#46; There was one case of brain tumour and one case of colon cancer&#46; Blood tumours amounted to 16&#37; of the cases in our series &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#41;&#58; 2 cases of acute myeloblastic leukaemia &#40;AML&#41; and 1 case of post-transplant lymphoproliferative disorder &#40;PTLD&#41;&#46; All three patients died of the secondary malignancy&#46; The latency period was shorter compared to solid tumours&#58; less than 1 year for 2 of the patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The indication for transplantation in almost every patient that developed a SMN &#40;17 out of 19 patients&#41; was a malignancy&#58; acute leukaemia in 12 patients and a solid tumour in 5 patients&#46; The non-malignant disorders that indicated HSCT were Fanconi anaemia and aplastic anaemia&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Eleven patients underwent autologous transplantation and 8 patients allogeneic transplantation&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> summarizes the characteristics of the patients&#44; the HSCTs and the SMNs&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">In this cohort&#44; 17 out of 19 patients had received irradiation&#46; During the conditioning&#44; 12 patients received TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41; and 2 patients thoracoabdominal irradiation &#40;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#46; Two patients that received TBI-based conditioning had also been treated with radiotherapy before&#58; 1 patient received whole brain radiotherapy &#40;19<span class="elsevierStyleHsp" style=""></span>Gy&#41; and 1 patient thoracic irradiation &#40;&#62;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#46; Three patients received radiotherapy only for treatment of the underlying disease&#44; but not during conditioning&#58; 1 patient whole brain radiotherapy &#40;19<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#44; 1 abdominal irradiation &#40;20<span class="elsevierStyleHsp" style=""></span>Gy&#41; and 1 thoracic irradiation &#40;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#46; The patients that received whole brain radiotherapy developed the late malignancy at a cranial site&#58; 1 osteosarcoma of the skullcap&#44; and 1 high-grade brain glioma&#46; The secondary malignancy was the cause of death in both cases&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The mortality in patients that developed a SMN was 47&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41;&#46; In all patients that died&#44; the cause was the secondary malignancy&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In the univariate analysis&#44; TBI-based conditioning was associated with an increased risk of SMN&#44; although the association was not statistically significant &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;73&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; Previous RT was associated with a 3-fold increase in risk that was statistically significant &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;1&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;04&#41;&#46; Chronic GvHD was significantly associated with an increased risk of malignancy &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">In the multivariate analysis&#44; TBI and chronic GvHD were the factors significantly associated with an increased risk of malignancy&#46; TBI increased the risk by four &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;3&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;03&#41; and chronic GVHD by more than fifteen &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;4&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46; Previous RT was not associated with an increase in risk in the multivariate analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">In our series&#44; acute GvHD was not associated with an increased risk of SMN&#46; We analysed other factors such as the type of HSCT&#44; the type of underlying disease&#44; age at HSCT&#44; and in vivo depletion of T-lymphocytes&#44; but none of them was associated with an increase in risk&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">To verify that malignancies in our cohort were more frequent compared to general population&#44; we compared the incidence in our cohort with the expected incidence in the general population for each age group&#46; The limited number of cases in our study did not allow us to perform a statistical analysis that strictly fulfilled the conditions required for the application of the test&#46; Nevertheless&#44; we confirmed that the incidence was much higher than expected in our cohort&#44; for each malignancy and in male as well as female patients&#44; and that the difference was statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">We obtained the population data we used for this analysis from the Spanish Cancer Registries Network &#40;Registre de C&#224;ncer de Tarragona&#44; Fundaci&#243; Lliga per a la Investigaci&#243; i Prevenci&#243; del C&#224;ncer&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">Several studies have reported that survivors of HSCT have an increased risk of secondary malignant neoplasms&#44; which are an important cause of late mortality&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The cumulative incidence in our study &#40;6&#37;&#44; 12&#37;&#44; and 36&#37; at 15&#44; 20&#44; and 30 years&#44; respectively&#41; confirms that the risk of SMN increases with time&#46; Interestingly&#44; although our data come from a single-centre cohort&#44; the proportions we observed are among the highest of those published&#46; For solid tumours&#44; the reported incidence in the largest series in the literature &#40;for more than 19<span class="elsevierStyleHsp" style=""></span>000 patients&#41; is 1&#37;&#8211;6&#37; at 10 years and 2&#37;&#8211;15&#37; at 15 years&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> The study published by the researchers of the Center for International Blood and Marrow Transplant Research &#40;CIBMTR&#41; and the Fred Hutchinson Cancer Research Center &#40;FHCRC&#41; reported 189 cases of secondary solid malignancies in a cohort of 28<span class="elsevierStyleHsp" style=""></span>874 allogeneic HSCT recipients &#40;adults and children&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> The cumulative incidence was 1&#37; at 10 years&#44; 2&#46;2&#37; at 15 years and 3&#46;3&#37; at 20 years after HSCT&#46; A European study with a cohort of 1036 patients found a cumulative incidence of solid tumours of 3&#46;5&#37; at 10 years and 12&#46;8&#37; at 15 years&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In our case series&#44; the most frequent secondary solid tumours were of the thyroid&#44; skin and breast&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Thyroid cancer is a typical radio-induced malignancy that is observed mainly in previously irradiated patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5&#44;6</span></a> However&#44; it has also been described as a secondary tumour after HSCT in patients that have never received irradiation&#44; which suggests that other mechanisms may be at play in the development of these tumours&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> Consistent with these findings&#44; we also found a case of papillary carcinoma in a patient with no history of irradiation&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The association between radiotherapy and an increased risk of basal cell carcinoma &#40;BCC&#41; is well known&#46; Indeed&#44; the basal membrane of epidermis&#44; where 70&#37; of proliferative cells are located&#44; is the most radiosensitive part of the skin&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> A Japanese study of survivors of the atomic bomb underscored that survivors were at increased risk of BCC compared to individuals who had not been exposed to ionizing radiation&#44; with a relative risk of 1&#46;8&#37; &#40;90&#37; CI&#44; 0&#46;8&#8211;&#46;3&#41;&#44; and that this risk increased with time&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> Skin cancers &#40;non-melanoma type&#41; typically develop in old age&#44; with a median age of onset of 64 years&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> Survivors of HSCT&#44; however&#44; develop skin malignancies at a younger age compared to the general population&#44; usually by 30 years of age&#44; as demonstrated by Perkins et al&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> In our cohort&#44; the 3 patients that developed basal cell carcinomas were aged 23&#44; 27&#44; and 34 years&#44; which confirmed the comparatively earlier onset&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">We found two cases of breast cancer that developed before age 30 years&#46; Early age at transplantation and TBI-based conditioning have been described as the main risk factors in the literature&#46; A collaborative study of the FHCRC and the EBMT published in 2008 evaluated the incidence of secondary breast cancer in survivors of allogeneic HSCT&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> This study found 52 cases of cancer in its cohort of 3337 women &#40;1026 of whom had undergone transplant at a paediatric age&#41;&#46; The cumulative incidence increased with time&#58; 0&#46;8&#37; at 10 years&#44; 4&#46;6&#37; at 20 years&#44; and 11&#37; at 25 years from HSCT&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In the literature&#44; secondary AML is related to high-dose chemotherapy and autologous HSCT&#59; development of leukaemia from donor cells in survivors of allogeneic HSCTs is extremely rare&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> A study in lymphoma patients with a minimum duration of follow-up of 5 years found a risk for developing AML after autologous HSCT of 3&#37;&#8211;19&#46;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> Similarly&#44; the 2 patients that developed AML in our cohort had undergone an autologous HSCT with a TBI-based conditioning regimen&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">When it comes to PTLD&#44; the reported incidence in large-scale series is very low &#40;1&#37;&#8211;1&#46;6&#37;&#41;&#44; and it is generally associated with a poor prognosis&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> Two main risk factors have been identified&#58; intensive immunosuppression&#44; and&#44; in many cases&#44; Epstein&#8211;Barr virus &#40;EBV&#41; reactivation&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> In the patient in our cohort&#44; PTLD was associated with EBV reactivation&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">One of the objectives of our study was to highlight the risk factors associated with developing a secondary malignancy&#46; Our study corroborated that radiotherapy is one of the main risk factors for SMNs&#46; Interestingly&#44; chronic GvHD was also a major risk factor for SMNs &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#46;4&#41;&#46; In the literature&#44; chronic GvHD has been associated with an increased risk of squamous cutaneous malignancies&#44; mainly in the oral cavity and skin&#46; Some series suggest that immunosuppressive therapy for management of chronic GVHD &#40;such as cyclosporine or azathioprine&#41; is a risk factor for SMNs&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Chronic inflammation and long-term immunosuppressive therapy can interfere with tissue repair&#44; increasing the risk of developing tumours&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Our results corroborate the role played by irradiation in the development of SMN&#46; Total body irradiation &#40;associated with cyclophosphamide&#41; has been the gold standard for conditioning before HSCT for many years&#46; The shift towards less toxic regimens without irradiation in the last decade may have the benefit of reducing the incidence of late complications such as SMN&#46; We need more time of follow-up to analyse the impact of these novel reduced-intensity conditioning regimens on the development of secondary tumours&#46; Another important aspect corroborated by our data is that chronic GvHD is a complication that seems to carry an increased risk of SMN&#46; Chronic GvHD prophylaxis thus appears to be the best available strategy to prevent late malignancies&#46; However&#44; its use must be carefully weighed against the associated increase in disease relapse in patients in whom HSCT was performed to treat malignant disease&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The high incidence of late malignancies highlights the need for life-long surveillance of HSCT survivors&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">One of the main strengths of our study was the long duration of follow-up&#44; as the incidence of secondary malignancies tends to increase with time&#44; and it allowed us to report several cases of SMN despite the small size of the study cohort&#46; In addition&#44; there were no losses to follow-up&#44; so we were able to report the actual incidence of SMNs&#46; There are also limitations to our study&#46; Despite the high number of SMNs we observed&#44; the small size of our cohort did not allow us to reach generalizable conclusions&#46; The heterogeneity in chemotherapy treatments for solid tumours and leukaemia prevented us from analysing the impact of these previous treatments on the risk of secondary malignancies&#46; Lastly&#44; we did not study the possible role in oncogenesis of other exogenous factors &#40;alcohol&#44; tobacco&#44; obesity&#44; hormonal treatment&#44; etc&#46;&#41; or genetic factors&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In conclusion&#44; subsequent malignant neoplasms constitute an important cause of morbidity and mortality in long-term survivors of hematopoietic stem cell transplantation&#46; We have observed a very high incidence of SMNs in patients that underwent HSCT in the paediatric age&#46; Radiotherapy and chronic GvHD were the main risk factors associated with the development of SMN in our study&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of interest</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres1157862"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Patients and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1085016"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1157863"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Pacientes y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1085015"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Definitions"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Statistical analysis"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Results"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Discussion"
        ]
        10 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conflicts of interest"
        ]
        11 => array:2 [
          "identificador" => "xack395067"
          "titulo" => "Acknowledgments"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-03-07"
    "fechaAceptado" => "2018-05-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1085016"
          "palabras" => array:4 [
            0 => "Hematopoietic stem cell transplantation"
            1 => "Subsequent malignant neoplasms"
            2 => "Radiotherapy"
            3 => "Chronic graft versus host disease"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1085015"
          "palabras" => array:4 [
            0 => "Trasplante hematopoy&#233;tico"
            1 => "Neoplasias malignas secundarias"
            2 => "Radioterapia"
            3 => "Enfermedad de injerto contra el hu&#233;sped cr&#243;nica"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Survival after hematopoietic stem cell transplantation has improved dramatically in recent years&#46; Unfortunately&#44; there is an increased risk of subsequent malignant neoplasms &#40;SMN&#41; in this population and this represents a significant cause of late mortality&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In this study&#44; we analysed the incidence of SMN and the associated risk factors in patients referred at a paediatric age for hematopoietic stem cell transplantation &#40;allogeneic or autologous&#41; in our centre&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We observed 19 cases of SMN in a cohort of 371 patients&#44; with a cumulative incidence of 6&#44; 12&#44; and 36&#37; at 15&#44; 20&#44; and 30 years of follow-up&#44; respectively&#46; The solid tumours were the most prevalent malignancies&#46; The risk was significantly higher than expected in the general population for each tumour type and in the different age ranges &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46; Radiotherapy and chronic GvHD were the main risk factors for the development of SMN in our series&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We observed a high incidence of SMN among hematopoietic stem cell transplantation survivors highlighting the need for life-long surveillance&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La supervivencia despu&#233;s del trasplante de progenitores hematopoy&#233;ticos ha mejorado de forma importante en los &#250;ltimos a&#241;os&#46; Desafortunadamente&#44; se ha descrito un mayor riesgo de neoplasias malignas secundarias &#40;NMS&#41; en esta poblaci&#243;n representando una causa importante de mortalidad tard&#237;a&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En este estudio&#44; analizamos la incidencia de NMS y los factores de riesgo asociados en los pacientes sometidos en edad pedi&#225;trica a un trasplante de progenitores hematopoy&#233;ticos &#40;alog&#233;nico o aut&#243;logo&#41; en nuestro centro&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Observamos 19 casos de NMS en una cohorte de 371 pacientes&#44; siendo la incidencia acumulada del 6&#44; 12 y 36&#37; a los 15&#44; 20 y 30 a&#241;os de seguimiento&#44; respectivamente&#46; Los tumores s&#243;lidos fueron los m&#225;s prevalentes&#46; El riesgo fue significativamente mayor de lo esperado en la poblaci&#243;n general para cada tipo de tumor y en los diferentes rangos de edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; La radioterapia y la EICH cr&#243;nica fueron los principales factores de riesgo para el desarrollo de NMS en nuestra serie&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Hemos observado una alta incidencia de neoplasias malignas secundarias en los supervivientes de un trasplante de progenitores hematopoy&#233;ticos evidenciando la necesidad de un seguimiento a largo plazo de esta poblaci&#243;n de pacientes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Sisinni L&#44; Gich I&#44; Torrent M&#44; Badell I&#46; Neoplasias malignas secundarias despu&#233;s de un trasplante de progenitores hematopoy&#233;ticos en edad pedi&#225;trica&#46; An Pediatr &#40;Barc&#41;&#46; 2019&#59;90&#58;157&#8211;164&#46;</p>"
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1010
            "Ancho" => 1520
            "Tamanyo" => 76410
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Cumulative incidence of SMNs&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1166
            "Ancho" => 2202
            "Tamanyo" => 110816
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Latency period until onset of SMN&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of neoplasm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;&#61;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Skin</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="char" valign="top">5</td><td class="td" title="table-entry  " align="left" valign="top">Alive &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Basal cell &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Dead &#40;1&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Squamous &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Melanoma &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Thyroid cancer</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Alive &#40;3&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Papillary &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Follicular &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gynaecological</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Alive &#40;3&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Breast carcinoma &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Uterus PNET &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sarcoma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Dead &#40;3&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Osteosarcoma &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Angiosarcoma &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Blood tumour</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="char" valign="top">3</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Dead &#40;3&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AML &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PTLD &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cerebral glioma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">1</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">Dead</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#40;Glioblastoma multiforme&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Colon cancer</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1977031.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Types of subsequent malignant neoplasms&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">CARBO&#58; carboplatin&#59; MEL&#58; melphalan&#59; Cy&#58; cyclophosphamide&#59; TBI&#58; total body irradiation&#59; CsA&#58; cyclosporine A&#59; MTX&#58; methotrexate&#59; MMF&#58; mycophenolate mofetil&#59; BM&#58; bone marrow&#59; PB&#58; peripheral blood&#59; UCB&#58; umbilical cord blood&#59; SD&#58; sibling donor&#59; MUD&#58; matched unrelated donor&#59; TT&#58; thiotepa&#59; TAI&#58; thoracoabdominal irradiation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pt&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex&#47;age at HCST &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HSCT type&#47;source&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Conditioning&#47;GvHD prophylaxis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Previous radiotherapy &#40;dose&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">GvHD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Secondary malignancy &#40;type&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age at malignancy &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vital status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cause of death&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Solid tumour<br>&#40;Wilms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">CARBO-VP16-MEL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;whole brain&#41;<br>&#40;12&#46;5&#8211;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Skull cap osteosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-SD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#47;CsA<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;whole brain&#41;<br>&#40;12&#46;5&#8211;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cerebral glioma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">T-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-SD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#47;CsA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;acute II&#59; chronic&#58; skin&#47;extensive&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uterus &#40;PNET&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-SD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#47;CsA<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;acute I&#59; chronic&#58; skin&#47;extensive&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Breast cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-SD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#47;CsA<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Basal cell carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Basal cell carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Solid tumour &#40;neuroblastoma&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;abdomen&#41;<br>&#40;12&#46;5&#8211;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Osteosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-MUD&#47;PB<br>Allo-MUD&#47;CB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">BU-Cy&#47;CsA<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MMF<br>FLU<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>other&#47;CsA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PTLD<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>EBV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Colon adenocarcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Basal cell cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-SD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#47;CsA<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Breast cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fanconi A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-SD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TAI &#40;&#60;10<span class="elsevierStyleHsp" style=""></span>Gy&#41;&#47;CsA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Skin squamous cell carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hodgkin lymphoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">VP16<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MEL<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;thoracic&#41;<br>&#40;12&#46;5&#8211;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Papillary thyroid cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B-ALL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-VP16-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Melanoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aplastic anaemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Allo-MUD&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TAI &#40;&#60;10<span class="elsevierStyleHsp" style=""></span>Gy&#41;-ATG&#47;CsA<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;acute I&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hepatic angiosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dead&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SMN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&#47;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Non-Hodgkin lymphoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy-TBI &#40;12&#46;5<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;thoracic&#41;<br>&#40;&#62;20<span class="elsevierStyleHsp" style=""></span>Gy&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Follicular thyroid cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&#47;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Solid tumour &#40;Wilms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Auto&#47;BM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cy<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Papillary thyroid cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1977033.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Patient and HSCT characteristics&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">TBI&#58; total body irradiation&#59; RT&#58; radiotherapy&#59; GvHD&#58; graft-versus-host disease&#59; OR&#58; odds ratio&#59; 95&#37; CI&#58; 95&#37; confidential interval for odds ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Factor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TBI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0&#8211;8&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0&#8211;9&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TBI<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&#8211;9&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at HSCT &#8805;10<span class="elsevierStyleHsp" style=""></span>y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&#8211;4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at HSCT &#60;10<span class="elsevierStyleHsp" style=""></span>y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;2&#8211;1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute GvHD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&#8211;1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic GvHD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;8&#8211;98&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Malignant disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&#8211;6&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nonmalignant disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&#8211;2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Auto-HSCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&#8211;2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Allo-HSCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&#8211;2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">In vivo T-cell depletion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&#8211;4&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1977030.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Risk factors for subsequent malignancies &#40;univariate analysis&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">TBI&#58; total body irradiation&#59; RT&#58; radiotherapy&#59; GvHD&#58; graft-versus-host disease&#59; OR&#58; odds ratio&#59; 95&#37; CI&#58; 95&#37; confidential interval for odds ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Factor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TBI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at HSCT &#8805;10<span class="elsevierStyleHsp" style=""></span>y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute GvHD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic GvHD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1977032.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Risk factors for subsequent malignancies &#40;multivariate analysis&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:16 [
            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Solid cancers after bone marrow transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;E&#46; Curtis"
                            1 => "P&#46;A&#46; Rowlings"
                            2 => "H&#46;J&#46; Deeg"
                            3 => "A&#46;S&#46; Donna"
                            4 => "G&#46; Soci&#233;"
                            5 => "L&#46;B&#46; Travis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199703273361301"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1997"
                        "volumen" => "336"
                        "paginaInicial" => "897"
                        "paginaFinal" => "904"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9070469"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New malignant diseases after allogeneic marrow transplantation for childhood acute leukemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Soci&#233;"
                            1 => "R&#46;E&#46; Curtis"
                            2 => "H&#46;J&#46; Deeg"
                            3 => "K&#46;A&#46; Sobocinski"
                            4 => "M&#46; Arora"
                            5 => "M&#46;M&#46; Horowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO.2000.18.2.348"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2000"
                        "volumen" => "18"
                        "paginaInicial" => "348"
                        "paginaFinal" => "357"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10637249"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Solid cancers after allogeneic hematopoietic cell transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;D&#46; Rizzo"
                            1 => "R&#46;E&#46; Curtis"
                            2 => "G&#46; Soci&#233;"
                            3 => "A&#46; Kathleen"
                            4 => "K&#46;A&#46; Sobocinski"
                            5 => "E&#46; Gilbert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1182/blood-2008-05-158782"
                      "Revista" => array:6 [
                        "tituloSerie" => "Blood"
                        "fecha" => "2009"
                        "volumen" => "113"
                        "paginaInicial" => "1175"
                        "paginaFinal" => "1183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18971419"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malignant neoplasms in long-term survivors of bone marrow transplantation&#46; Late Effects Working Party of the European Cooperative Group for Blood and Marrow Transplantation and the European Late Effects Project Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;J&#46; Kolb"
                            1 => "G&#46; Soci&#233;"
                            2 => "T&#46; Duell"
                            3 => "M&#46;T&#46; van Lint"
                            4 => "A&#46; Tichelli"
                            5 => "J&#46;F&#46; Apperley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1999"
                        "volumen" => "131"
                        "paginaInicial" => "738"
                        "paginaFinal" => "744"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10577296"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673605711417"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Acharya"
                            1 => "K&#46; Sarafoglou"
                            2 => "M&#46; LaQuaglia"
                            3 => "S&#46; Lindsley"
                            4 => "W&#46; Gerald"
                            5 => "N&#46; Wollner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.11362"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2003"
                        "volumen" => "97"
                        "paginaInicial" => "2397"
                        "paginaFinal" => "2403"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of thyroid cancer in survivors of childhood cancer&#58; results from the British Childhood Cancer Survivor Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Taylor"
                            1 => "A&#46;P&#46; Croft"
                            2 => "A&#46;M&#46; Palace"
                            3 => "D&#46;L&#46; Winter"
                            4 => "R&#46;C&#46; Reulen"
                            5 => "C&#46;A&#46; Stiller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ijc.24581"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cancer"
                        "fecha" => "2009"
                        "volumen" => "125"
                        "paginaInicial" => "2400"
                        "paginaFinal" => "2405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19610069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk for secondary thyroid carcinoma after hematopoietic stemcell transplantation&#58; an EBMT Late Effects Working Party Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Cohen"
                            1 => "A&#46; Rovelli"
                            2 => "D&#46;F&#46; Merlo"
                            3 => "M&#46;T&#46; van Lint"
                            4 => "E&#46; Lanino"
                            5 => "D&#46; Bresters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO. 9276 200608"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2007"
                        "volumen" => "25"
                        "paginaInicial" => "2449"
                        "paginaFinal" => "2454"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17557958"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "DNA Damage&#44; apoptosis and langerhans cells &#8211; activators of UV-induced immune tolerance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Timares"
                            1 => "S&#46; Katiyar"
                            2 => "C&#46;A&#46; Elmets"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1751-1097.2007.00284.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Photochem Photobiol"
                        "fecha" => "2008"
                        "volumen" => "84"
                        "paginaInicial" => "422"
                        "paginaFinal" => "436"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18248501"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109715042709"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skin tumor risk among atomic-bomb survivors in Japan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Ron"
                            1 => "D&#46;L&#46; Preston"
                            2 => "M&#46; Kishikawa"
                            3 => "T&#46; Kobuke"
                            4 => "M&#46; Iseki"
                            5 => "S&#46; Tokuoka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "1998"
                        "volumen" => "9"
                        "paginaInicial" => "393"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9794171"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonmelanoma skin cancer in survivors of childhood and adolescent cancer&#58; a report from the childhood cancer survivor study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Perkins"
                            1 => "Y&#46; Liu"
                            2 => "P&#46;A&#46; Mitby"
                            3 => "J&#46;P&#46; Neglia"
                            4 => "S&#46; Hammond"
                            5 => "M&#46; Stovall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1200/JCO. 237 200506"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Oncol"
                        "fecha" => "2005"
                        "volumen" => "23"
                        "paginaInicial" => "3733"
                        "paginaFinal" => "3741"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15923570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased risk of breast cancer among survivors of allogeneic hematopoietic cell transplantation&#58; a report from the FHCRC and the EBMT-Late Effect Working Party"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;L&#46; Friedman"
                            1 => "A&#46; Rovo"
                            2 => "W&#46; Leisenring"
                            3 => "A&#46; Locasciulli"
                            4 => "M&#46; Flowers"
                            5 => "A&#46; Tichelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1182/blood-2007-07-099283"
                      "Revista" => array:7 [
                        "tituloSerie" => "Blood"
                        "fecha" => "2008"
                        "volumen" => "111"
                        "paginaInicial" => "939"
                        "paginaFinal" => "944"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17911386"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109713050924"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Donor cell leukemia&#58; insight into cancer stem cells and the stem cell niche"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;M&#46; Flynn"
                            1 => "D&#46;S&#46; Kaufman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1182/blood-2006-07-021980"
                      "Revista" => array:6 [
                        "tituloSerie" => "Blood"
                        "fecha" => "2007"
                        "volumen" => "109"
                        "paginaInicial" => "2688"
                        "paginaFinal" => "2692"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17132724"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapy-related acute myeloid leukemia and myelodysplasia after high-dose chemotherapy and autologous stem cell transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Pedersen-Bjergaard"
                            1 => "M&#46;K&#46; Andersen"
                            2 => "D&#46;H&#46; Christiansen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Blood"
                        "fecha" => "2000"
                        "volumen" => "95"
                        "paginaInicial" => "3273"
                        "paginaFinal" => "3279"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10828005"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of lymphoproliferative disorders after bone marrow transplantation&#58; a multi-institutional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;E&#46; Curtis"
                            1 => "L&#46;B&#46; Travis"
                            2 => "P&#46;A&#46; Rowlings"
                            3 => "G&#46; Soci&#233;"
                            4 => "D&#46;W&#46; Kingma"
                            5 => "P&#46;M&#46; Banks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Blood"
                        "fecha" => "1999"
                        "volumen" => "94"
                        "paginaInicial" => "2208"
                        "paginaFinal" => "2216"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "B cell lymphoproliferative disorders following hematopoietic stem cell transplantation&#58; risk factors&#44; treatment and outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;G&#46; Gross"
                            1 => "M&#46; Steinbuch"
                            2 => "T&#46; DeFor"
                            3 => "R&#46;S&#46; Shapiro"
                            4 => "P&#46; McGlave"
                            5 => "N&#46;K&#46; Ramsay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.bmt.1701554"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bone Marrow Transplant"
                        "fecha" => "1999"
                        "volumen" => "23"
                        "paginaInicial" => "251"
                        "paginaFinal" => "258"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10084256"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of chronic GVHD therapy on the development of squamous-cell cancers after hematopoietic stem-cell transplantation&#58; an international case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;E&#46; Curtis"
                            1 => "C&#46; Metayer"
                            2 => "J&#46;D&#46; Rizzo"
                            3 => "G&#46; Soci&#233;"
                            4 => "K&#46;A&#46; Sobocinski"
                            5 => "M&#46;E&#46; Flowers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1182/blood-2004-09-3411"
                      "Revista" => array:6 [
                        "tituloSerie" => "Blood"
                        "fecha" => "2005"
                        "volumen" => "105"
                        "paginaInicial" => "3802"
                        "paginaFinal" => "3811"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15687239"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack395067"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0185" class="elsevierStylePara elsevierViewall">We want to thank Jaume Galceran&#44; head of the Spanish Cancer Registries Network&#44; Registre de C&#224;ncer de Tarragona&#44; Fundaci&#243; Lliga per a la Investigaci&#243; i Prevenci&#243; del C&#224;ncer&#44; Reus &#40;Tarragona&#44; Spain&#41;&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000009000000003/v1_201903020636/S2341287918301686/v1_201903020636/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009000000003/v1_201903020636/S2341287918301686/v1_201903020636/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287918301686?idApp=UINPBA00005H"
]

Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2018.10.002

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	7	12	19
2024 October	29	36	65
2024 September	42	35	77
2024 August	43	62	105
2024 July	28	33	61
2024 June	33	23	56
2024 May	25	29	54
2024 April	38	33	71
2024 March	25	14	39
2024 February	25	31	56
2024 January	24	18	42
2023 December	29	22	51
2023 November	38	37	75
2023 October	32	37	69
2023 September	26	26	52
2023 August	16	17	33
2023 July	29	24	53
2023 June	31	31	62
2023 May	30	21	51
2023 April	18	13	31
2023 March	35	21	56
2023 February	27	15	42
2023 January	15	18	33
2022 December	40	23	63
2022 November	36	40	76
2022 October	48	40	88
2022 September	35	23	58
2022 August	41	50	91
2022 July	38	46	84
2022 June	35	35	70
2022 May	45	40	85
2022 April	35	27	62
2022 March	43	59	102
2022 February	25	35	60
2022 January	56	35	91
2021 December	36	45	81
2021 November	42	50	92
2021 October	51	68	119
2021 September	43	39	82
2021 August	39	43	82
2021 July	26	32	58
2021 June	30	45	75
2021 May	33	50	83
2021 April	121	101	222
2021 March	47	41	88
2021 February	29	28	57
2021 January	34	32	66
2020 December	30	33	63
2020 November	22	37	59
2020 October	20	25	45
2020 September	30	20	50
2020 August	19	28	47
2020 July	13	45	58
2020 June	18	23	41
2020 May	38	21	59
2020 April	16	15	31
2020 March	18	9	27
2020 February	18	16	34
2020 January	21	6	27
2019 December	41	7	48
2019 November	21	16	37
2019 October	35	12	47
2019 September	19	14	33
2019 August	45	21	66
2019 July	36	17	53
2019 June	19	21	40
2019 May	32	7	39
2019 April	34	38	72
2019 March	101	32	133
2019 February	34	14	48
2019 January	31	9	40
2018 December	30	8	38
2018 November	38	20	58
2018 October	12	3	15

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter