1
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Gardner UG, Wood SG, Chen EY, Greenberger JS, Grossberg AJ. Use of a Therapeutic Trial of Graduated Neoadjuvant Radiation Therapy for Locally Advanced Esophageal Cancer in a Patient With Fanconi Anemia. Adv Radiat Oncol 2022; 7:100810. [PMID: 34765806 PMCID: PMC8570958 DOI: 10.1016/j.adro.2021.100810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/09/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023] Open
Affiliation(s)
- Ulysses G. Gardner
- Department of Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Stephanie G. Wood
- Department of Surgery, Oregon Health and Science University, Portland, Oregon
| | - Emerson Y. Chen
- Division of Hematology and Medical Oncology, Department of Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Joel S. Greenberger
- Department of Radiation Oncology, The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Aaron J. Grossberg
- Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
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2
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Yanagisawa K, Horiuchi T, Matsuo A, Kuraishi H, Satomi H, Ito I, Noguchi T, Sekiguchi N, Kanda S, Koizumi T. Serial Cancer Development Three Times in a Patient with Fanconi Anemia. Case Rep Oncol 2021; 14:1168-1174. [PMID: 34703432 PMCID: PMC8460962 DOI: 10.1159/000518076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/15/2021] [Indexed: 11/21/2022] Open
Abstract
Fanconi anemia (FA) is characterized clinically by bone marrow failure, congenital malformations, sensitivity to DNA cross-linking agents, and increased risk of malignancy. Hematological cancer is the best-described malignancy in patients with FA, but the susceptibility to the development of solid tumors is also well documented, especially after hematopoietic stem cell transplantation (HSCT). With regard to the development of solid tumors in patients with FA, head and neck, esophageal, and anal squamous cell carcinoma are well known, but reports of lung cancer are extremely rare. Here, we describe an FA patient with a history of HSCT that developed 3 serial cancers − oral, esophageal, and nonsmall cell lung cancer − over a period of 6 years. The third lesion was nonsmall cell lung cancer and its location corresponded closely to the field of irradiation treatment for prior esophageal cancer. The occurrence of lung cancer in patients with FA is uncommon, but FA patients should be screened regularly and serially. Our case also indicated the importance of the irradiated field as a location for subsequent cancer development.
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Affiliation(s)
- Katsuya Yanagisawa
- Department of Pulmonary Medicine, Minami Nagano Iryou Center, Shinonoi Hospital, Nagano, Japan
| | - Toshimichi Horiuchi
- Department of Pulmonary Medicine, Minami Nagano Iryou Center, Shinonoi Hospital, Nagano, Japan
| | - Akemi Matsuo
- Department of Pulmonary Medicine, Minami Nagano Iryou Center, Shinonoi Hospital, Nagano, Japan
| | - Hiroshi Kuraishi
- Department of Pulmonary Medicine, Nagano Red Cross Hospital, Nagano, Japan
| | - Hidetoshi Satomi
- Department of Pathology, Nagano Red Cross Hospital, Nagano, Japan
| | - Ichiro Ito
- Department of Pathology, Nagano Red Cross Hospital, Nagano, Japan
| | - Takuro Noguchi
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Nodoka Sekiguchi
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shintaro Kanda
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tomonobu Koizumi
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
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Fujisawa M, Matsushima M, Ueda T, Kaneko M, Fujimoto R, Sano M, Teramura E, Monma M, Mizukami H, Nakahara F, Suzuki H, Suzuki T, Yabe M, Yabe T. Three Cases of Esophageal Cancer Related to Fanconi Anemia. Intern Med 2021; 60:2953-2959. [PMID: 33814498 PMCID: PMC8502673 DOI: 10.2169/internalmedicine.6926-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The risk of carcinogenesis increases after 20 years old in patients with Fanconi anemia (FA). We herein report three rare cases of FA combined with esophageal cancer in women; all patients were diagnosed with FA in early childhood. Patients 1 and 2 were diagnosed with advanced and superficial esophageal cancer, respectively, at 21 and 30 years old, respectively. Patient 3 was diagnosed with superficial esophageal cancer, underwent curative surgery at 26 years old, and survived for over 5 years without recurrence. Therefore, establishing a protocol for the early detection of esophageal cancer in FA patients over 20 years old is important.
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Affiliation(s)
- Mia Fujisawa
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Masashi Matsushima
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Takashi Ueda
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Motoki Kaneko
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Ryutaro Fujimoto
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Masaya Sano
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Erika Teramura
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Makiko Monma
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Hajime Mizukami
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Fumio Nakahara
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Hidekazu Suzuki
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Takayoshi Suzuki
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University, School of Medicine, Japan
| | - Miharu Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University, School of Medicine, Japan
| | - Toshimasa Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University, School of Medicine, Japan
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Lee RH, Kang H, Yom SS, Smogorzewska A, Johnson DE, Grandis JR. Treatment of Fanconi Anemia-Associated Head and Neck Cancer: Opportunities to Improve Outcomes. Clin Cancer Res 2021; 27:5168-5187. [PMID: 34045293 DOI: 10.1158/1078-0432.ccr-21-1259] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
Fanconi anemia, the most frequent genetic cause of bone marrow failure, is characterized by an extreme predilection toward multiple malignancies, including a greater than 500-fold incidence of head and neck squamous cell carcinoma (HNSCC) relative to the general population. Fanconi anemia-associated HNSCC and esophageal SCC (FA-HNSCC) often present at advanced stages with poor survival. Surgical resection remains the primary treatment for FA-HNSCC, and there is often great reluctance to administer systemic agents and/or radiotherapy to these patients given their susceptibility to DNA damage. The paucity of FA-HNSCC case reports limits evidence-based management, and such cases have not been analyzed collectively in detail. We present a systematic review of FA-HNSCC treatments reported from 1966 to 2020, defining a cohort of 119 patients with FA-HNSCC including 16 esophageal SCCs (131 total primary tumors), who were treated with surgery, radiotherapy, systemic therapy (including cytotoxic agents, EGFR inhibitors, or immune checkpoint inhibitors), or a combination of modalities. We summarize the clinical responses and regimen-associated toxicities by treatment modality. The collective evidence suggests that when possible, surgical resection with curative intent should remain the primary treatment modality for FA-HNSCC. Radiation can be administered with acceptable toxicity in the majority of cases, including patients who have undergone stem cell transplantation. Although there is little justification for cytotoxic chemotherapy, EGFR inhibitors and tyrosine kinase inhibitors may be both safe and effective. Immunotherapy may also be considered. Most oncologists have little personal experience with FA-HNSCC. This review is intended as a comprehensive resource for clinicians.
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Affiliation(s)
- Rex H Lee
- Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - Hyunseok Kang
- Department of Medicine, University of California San Francisco, San Francisco, California
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Agata Smogorzewska
- Laboratory of Genome Maintenance, The Rockefeller University, New York, New York
| | - Daniel E Johnson
- Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - Jennifer R Grandis
- Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, California
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Ino A, Sakanaka K, Inoo H, Ishida Y, Kanda J, Mizowaki T. Definitive radiotherapy for secondary esophageal cancer after allogeneic hematopoietic stem cell transplantation. Int Cancer Conf J 2021; 10:201-206. [PMID: 34221832 DOI: 10.1007/s13691-021-00479-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/13/2021] [Indexed: 01/30/2023] Open
Abstract
The reports for secondary esophageal cancer treated by radiotherapy or chemoradiotherapy is few, however they potentially yield a cure for esophageal cancer. We report a case of definitive radiotherapy for a patient with secondary locally advanced unresectable esophageal cancer after hematopoietic stem cell transplantation for acute myeloid leukemia. Definitive radiotherapy for the current patient was completed with acceptable toxicity despite the poor general condition with long-term chronic graft-versus-host disease. Radiotherapy may be the definitive treatment for this population unfit for concurrent chemotherapy or surgery.
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Affiliation(s)
- Aki Ino
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Katsuyuki Sakanaka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Hiroyuki Inoo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Yuichi Ishida
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
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Radiation Therapy in a Perineal Squamous Cell Carcinoma in a Patient With Fanconi Anemia: A Case Report and Review of Literature. Adv Radiat Oncol 2020; 6:100546. [PMID: 33506142 PMCID: PMC7814099 DOI: 10.1016/j.adro.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/08/2020] [Accepted: 08/03/2020] [Indexed: 11/23/2022] Open
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Anak S, Yalman N, Bilgen H, Sepet E, Deviren A, Gürtekin B, Tunca F, Başaran B. Squamous cell carcinoma development in Fanconi anemia patients who underwent hematopoietic stem cell transplantation. Pediatr Transplant 2020; 24:e13706. [PMID: 32255560 DOI: 10.1111/petr.13706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 12/29/2022]
Abstract
We examined SCC development of 24 FA patients, who received HSCT from HLA-matched relatives. In our BMT center, we applied low-dose CY + LFI + ATG (n:13) as conditioning regimen for FA patients between 1992 and 1999, and CY + BU + ATG (n:11) between 1999 and 2002. The aim of this study was to investigate SCC development after HSCT and examine features of the follow-up patients. The 10-year overall survival (OS) of the group with LFI + regimen was 43%, whereas the group without LFI regimen was 60%. There was a statistically significant relationship between infections (viral/bacterial) and overall survival (Fisher's Exact test P < .001). Five out of 13 long-term (>1 year) surviving patients developed SCC in the HNSCC (n:4) and esophagus (n:2) region (a patient with oral SCC developed a second primary esophageal SCC). The SCC rate in our FA patients was 38%, four of the SCC patients were transplanted with irradiation used conditioning regimens, three of them had acuteGvHD (Grade II-III), only one developed chronic GvHD. The interval between HSCT and SCC diagnosis was median 13 (range 6-18) years, the age for the development of cancer was median 21 (range 15-32) years. Survival after SCC was low, median 6 months (range 6-12), due to delayed SCC diagnosis, tumor progression under therapy and treatment-related toxicities of the usually reduced RT and/or CT.
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Affiliation(s)
- Sema Anak
- Department of Pediatric Hematology Oncology BMT Unite, Faculty of Medicine, Medipol University, İstanbul, Turkey
| | - Nevin Yalman
- Department of Medical Biology, Faculty of Istanbul Medicine, Istanbul University, İstanbul, Turkey
| | - Hülya Bilgen
- Department of Pediatric Hematology Oncology BMT Unite, Faculty of Medicine, Medipol University, İstanbul, Turkey
| | - Elif Sepet
- Faculty of Dentistry, Istanbul Kent University, İstanbul, Turkey
| | - Ayhan Deviren
- Department of Medical Biology and Genetics, Faculty of Cerrahpasa Medicine, Istanbul Cerrahpasa University, Istanbul, Turkey
| | - Başak Gürtekin
- Department of Biostatistics, Faculty of Istanbul Medicine, Istanbul University, İstanbul, Turkey
| | - Fatih Tunca
- Department of Surgery, Faculty of Istanbul Medicine, Istanbul University, İstanbul, Turkey
| | - Bora Başaran
- Department of Otorhinolaryngology, Faculty of Istanbul Medicine, Istanbul University, İstanbul, Turkey
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8
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Touil D, Bouhouch R, Chebil RB, Oualha L, Douki N. Gingival Bleeding in a Child with Fanconi Anemia: A Case Report and Literature Review. Case Rep Dent 2020; 2020:3161053. [PMID: 32231808 PMCID: PMC7085353 DOI: 10.1155/2020/3161053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/13/2020] [Accepted: 02/17/2020] [Indexed: 11/18/2022] Open
Abstract
Fanconi anemia (FA) is a rare autosomal recessive disorder characterized by multiple congenital abnormalities, bone marrow failure, and higher susceptibility to malignancies, especially to head and neck carcinomas. Only few reports about the oral manifestations of FA are available. The main reported oral conditions associated with FA are microdontia and advanced periodontitis. The aim of this paper was to report a case of a 10-year-old patient with FA presenting severe spontaneous gingival bleeding, as well as to discuss the role of the dentist in the management and treatment of this condition.
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Affiliation(s)
- Dorsaf Touil
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Rahma Bouhouch
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Raoua Belkacem Chebil
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Lamia Oualha
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Nabiha Douki
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
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9
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Esophagectomy for the patients with squamous cell carcinoma of the esophagus after allogeneic hematopoietic stem cell transplantation. Int J Clin Oncol 2019; 25:82-88. [PMID: 31549271 DOI: 10.1007/s10147-019-01549-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/10/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND The number of long-term survivors after allogeneic hematopoietic stem cell transplantation (HSCT) has increased recently. Esophageal squamous cell carcinoma occurs at a particularly high incidence as a secondary cancer after HSCT. However, standard treatment for these patients has not been established yet. The objectives of this study were to investigate outcomes of esophagectomy for esophageal carcinoma developed in HSCT patients, and to provide the appropriate perioperative management. METHODS Ten HSCT patients underwent esophagectomy for esophageal squamous cell carcinoma between December 2007 and September 2017 at the National Cancer Center Hospital. The surgical outcomes and long-term prognosis of these patients were reviewed retrospectively. RESULTS In the former group, 5 of the 7 patients (71.4%) developed pneumonia after esophagectomy, with two of them requiring intubation because of respiratory failure. None of the three patients of the latter group, who received broad-spectrum antibiotics for more than 7 days after the surgery, developed any postoperative complications. The estimated survival probability of these patients at 5 years after the surgery was 53.3%. CONCLUSIONS HSCT patients have an extremely high risk of developing pneumonia after esophagectomy, and the condition can easily become serious. Therefore, broad-spectrum antibiotics should be administered prophylactically to prevent severe pneumonia during the perioperative period in these patients.
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Onishi S, Tajika M, Tanaka T, Ishihara M, Hirayama Y, Mizuno N, Kuwahara T, Okuno N, Matsumoto S, Toriyama K, Kurita Y, Obata M, Koide Y, Hasegawa Y, Hara K, Niwa Y. Superficial Esophageal Cancer in a Fanconi Anemia Patient That Was Treated Successfully by Endoscopic Submucosal Resection. Intern Med 2019; 58:529-533. [PMID: 30333403 PMCID: PMC6421153 DOI: 10.2169/internalmedicine.1434-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/02/2018] [Indexed: 11/06/2022] Open
Abstract
Fanconi anemia (FA) is a disorder of chromosomal fragility characterized by progression to aplastic anemia, myelodysplastic syndrome, and leukemia. FA patients are also predisposed to solid cancers. A case of FA in an adult patient who developed tongue and superficial esophageal cancers following hematopoietic stem cell transplantation is reported. This case was considered significant because it is the first reported case of superficial esophageal cancer in an FA patient that was treated successfully by endoscopic submucosal resection.
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Affiliation(s)
- Sachiyo Onishi
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Tsutomu Tanaka
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Makoto Ishihara
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Yutaka Hirayama
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | | | - Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | | | | | - Yusuke Kurita
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Masanori Obata
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Yusuke Koide
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Yasumasa Niwa
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
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Oral Reconstruction Using Medial Sural Artery Perforator Flap in a Patient With Fanconi Anemia. J Craniofac Surg 2016; 27:822. [PMID: 27100650 DOI: 10.1097/scs.0000000000002584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Sculier J, Botta I, Bucalau A, Compagnie M, Eskenazi A, Fischler R, Gorham J, Mans L, Rozen L, Speybrouck S, Wang X, Meert A, Berghmans T. Medical anticancer treatment of lung cancer associated with comorbidities: A review. Lung Cancer 2015; 87:241-8. [DOI: 10.1016/j.lungcan.2015.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 01/09/2015] [Indexed: 12/26/2022]
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13
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Sirák I, Šinkorová Z, Šenkeříková M, Špaček J, Laco J, Vošmiková H, John S, Petera J. Hypersensitivity to chemoradiation in FANCA carrier with cervical carcinoma-A case report and review of the literature. Rep Pract Oncol Radiother 2014; 20:309-15. [PMID: 26109920 DOI: 10.1016/j.rpor.2014.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/01/2014] [Accepted: 11/17/2014] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Compared to Fanconi anemia (FA) patients with homozygous defective two-alleles inheritance, there is a scarce or no evidence on one defective allele FANCA carriers, with respect to their cancer incidence, clinical and in vitro radiosensitivity and chemosensitivity. On that account, we report a case of a 30-year old FANCA mutation carrier woman with uterine cervix adenocarcinoma who was treated with chemoradiotherapy, in which unexpected acute toxicity and fatal late morbidity occured. METHODS We also report the results of an in vitro test for radiosensitivity, immunohistochemical examination with FANCA staining and human papillomavirus genotypization, and a review of the literature for FA carrier patients with respect to cancer incidence, clinical and in vitro response to chemo/radiotherapy, options of early heterozygosity detection, and methods of in vitro prediction of hypersensitivity to oncologic treatment. CONCLUSION Although there are no standard guidelines for management of FA carriers with malignancies and reports about chemo- or radiosensitivity in this population are scarce; patients with FA-A heterozygosity may have a high rate of complications from chemo/radiotherapy. Up to now, an optimum method for the prediction of radiosensitivity and the best parameter has not been found. Clinical radioresponsiveness is unpredictable in FA carriers and there is a pressing need of new rapid and predictive in vitro assays of radiation responses. Until then, the treatment of FA carriers with malignancies should be individualized, with respect to potential hypersensitivity to ionizing radiation or cross-linking agents.
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Affiliation(s)
- Igor Sirák
- Department of Oncology and Radiotherapy, University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Zuzana Šinkorová
- Department of Radiobiology, Faculty of Health Sciences, University of Defence in Brno, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Mária Šenkeříková
- Department of Medical Genetics, University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Jiří Špaček
- Department of Gynecology and Obstetrics, University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Jan Laco
- The Fingerland Department of Pathology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Hana Vošmiková
- The Fingerland Department of Pathology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Stanislav John
- Department of Oncology and Radiotherapy, University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
| | - Jiří Petera
- Department of Oncology and Radiotherapy, University Hospital Hradec Králové, Sokolská 581, Hradec Kralove 500 05, Czech Republic
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Miyawaki Y, Imoto I, Tokairin Y, Kawada K, Nakajima Y, Nishikage T, Nagai K, Kajiwara M, Inazawa J, Kawano T. Esophageal squamous cell carcinoma developed 11 years after allogeneic bone marrow transplantation for acute lymphatic leukemia. Jpn J Clin Oncol 2012; 43:69-73. [PMID: 23225908 DOI: 10.1093/jjco/hys184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Younger patients (aged <30 years) presenting with esophageal cancer are rare. Bone marrow transplantation offers a curative therapy in patients with malignant and nonmalignant lymphohematopoietic diseases and other disorders. However, one important late complication in transplantation survivors is the development of secondary malignancies including solid tumors. Although some solid cancers have been demonstrated to occur after bone marrow transplantation, only a few cases of esophageal squamous cell carcinoma have thus far been reported. We herein describe the case of a 27-year-old male with esophageal squamous cell carcinoma, who was diagnosed with T-cell-type acute lymphatic leukemia at the age of 12 and relapsed 5 years later. He achieved a second complete remission and underwent bone marrow transplantation at the age of 17. A genetic analysis revealed germ-line lineage-derived chimeric cellular populations of the donor and patient on both the esophageal squamous cell carcinoma and non tumorous portions of the patient's esophageal mucosa with a preponderance of the patient's germ-line lineage-derived cells, suggesting that repopulated donor-derived hemopoietic stem cells in the esophageal epithelia only partially contributed to the carcinogenesis of esophageal squamous cell carcinoma several years after bone marrow transplantation. Multiple events occurring during the course of treatment for primary hematological disorder may play an important role in the development of esophageal squamous cell carcinoma.
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Affiliation(s)
- Yutaka Miyawaki
- Department of Esophago-Gastric Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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Scheckenbach K, Wagenmann M, Freund M, Schipper J, Hanenberg H. Squamous cell carcinomas of the head and neck in Fanconi anemia: risk, prevention, therapy, and the need for guidelines. KLINISCHE PADIATRIE 2012; 224:132-8. [PMID: 22504776 DOI: 10.1055/s-0032-1308989] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Fanconi anemia (FA) is a rare recessive DNA repair disorder that is clinically characterized by congenital malformations, progressive bone marrow failure, and increased incidence of malignancies, especially acute myeloid leukemia and squamous cell carcinomas of the head and neck (HNSCCs) and the anogenital regions. On a cellular level, typical features of the disorder are a high degree of genomic instability and an increased sensitivity to bi-functionally alkylating agents. So far, germ-line defects in 15 different FA genes have been identified. Some of these FA genes are also established as tumor susceptibility genes for familiar cancers.In recent years, the prevention and therapy of HNSCCs in FA patients has become more important as the percentage of patients surviving into adulthood is rising. HNSCCs appear in very young FA patients without common risk factors. Since cisplatin-based chemotherapy in combination with radiotherapy, essential parts of the standard treatment approach for sporadic HNSCCs, cannot be used in FA patients due to therapy-associated toxicities and mortalities even with reduced dosing, surgery is the most important treatment option for HNSCCs, in FA patients and requires an early and efficient detection of malignant lesions. So far, no uniform treatment protocol for the management of HNSCCs in FA patients exists. Therefore, we propose that the information on affected FA patients should be collected worldwide, practical therapeutic guidelines developed and national treatment centers established.
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Affiliation(s)
- K Scheckenbach
- Department of Otorhinolaryngology/Head and Neck Surgery, Heinrich Heine University, Düsseldorf, Germany
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Hucl T, Gallmeier E. DNA repair: exploiting the Fanconi anemia pathway as a potential therapeutic target. Physiol Res 2011; 60:453-65. [PMID: 21401292 DOI: 10.33549/physiolres.932115] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
DNA repair is an active cellular process to respond to constant DNA damage caused by metabolic processes and environmental factors. Since the outcome of DNA damage is generally adverse and long term effects may contribute to oncogenesis, cells have developed a variety of DNA repair mechanisms, which operate depending on the type of DNA damage inflicted. At least 15 Fanconi anemia (FA) proteins interact in a common pathway involved in homologous recombination. Inherited homozygous mutations in any of these FA genes cause a rare disease, Fanconi anemia, characterized by congenital abnormalities, progressive bone-marrow failure and cancer susceptibility. Heterozygous germline FA mutations predispose to various types of cancer. In addition, somatic FA mutations have been identified in diverse cancer types. Evidence exists that cells deficient in the FA pathway become dependent on alternative pathways for survival. Additional inhibition of such alternative pathways is thus expected to result in cell death, creating a relationship of synthetic lethality. Identifying these relationships can reveal yet unknown mechanisms of DNA repair and new targets for therapy.
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Affiliation(s)
- T Hucl
- Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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