Alia Cibich

Blood cancers (when combined) are both the second most diagnosed and common cause of cancer-related mortality in Australia. There are more than 110,000 people living with blood cancer in Australia today, projected to increase to 275,000 people by 2035.

Haematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for many high-risk blood cancers such as acute myeloid leukaemia. It is arguably the most intensive form of cancer treatment. Advancements in clinical practice have led to improved outcomes and increased survivorship. However, long-term survivors experience significant late morbidity and risk of mortality due to treatment-associated toxicities. Perhaps the most devastating late complication of HSCT is development of new secondary cancers in patients otherwise cured of their blood cancer.

Secondary cancers are highly heterogenous, with reports of malignancy in essentially all tissues/organs. Unlike many other complications of HSCT, secondary cancers are poorly described. Reported incidence and latency is highly variable, and pathogenesis inadequately understood. Consequently, minimal guidance is available to clinicians for the management of patients. Furthermore, existing data does not consider contemporary clinical practice. Thus, investigation of these gaps has potential to inform development of a risk-stratified clinical algorithm and identify novel therapeutic targets. Clinicians will be better equipped to make informed decisions on treatment plans, and patients will benefit from improved procedural safety by proactive risk management.