{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:46:59Z","timestamp":1792597619851,"version":"4.5.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"\n Importance<\/jats:title>\n Blood or marrow transplant (BMT) recipients are at increased risk of developing subsequent cutaneous malignant neoplasms. There is a need to develop risk stratification tools to identify those at highest risk to inform dermatologic surveillance and evaluate risk mitigation strategies.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To develop and validate a risk stratification tool for subsequent cutaneous malignant neoplasms among BMT recipients that incorporates readily available patient and treatment information.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This prognostic study included participants in the multi-institutional, longitudinal BMT Survivor Study (BMTSS), which included individuals who underwent autologous or allogeneic BMT from January 1, 1974, to December 31, 2014, at 1 of 3 participating sites in California, Minnesota, and Alabama and survived 2 or more years after BMT. The present cohort was restricted to individuals who underwent a single transplant and completed at least 1 BMTSS survey. Data were analyzed from December 3, 2024, to June 3, 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Risk stratification models included the following candidate variables: age at BMT, sex, race, ethnicity, prior cutaneous malignant neoplasm, pretransplant exposure to monoclonal antibodies, total body irradiation, chronic graft vs host disease, and posttransplant immunosuppression.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcomes were incident basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or melanoma after BMT, ascertained based on participant report with medical record validation when available. Models for risk stratification were developed and validated using time-dependent area under the receiver operating characteristic (AUC) curve with repeated random partitioning into training and testing cohorts. Results were averaged to make a final model. Individuals were classified into low or high risk for subsequent cutaneous malignant neoplasm based on clinically meaningful risk stratification score thresholds.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 3448 included BMTSS participants (1917 [55.6%] male; mean [SD] age at BMT, 41.9 [19.2] years) who were alive without a cutaneous malignant neoplasm event 2 years after BMT, 282 (8.2%) were diagnosed with BCC, 183 (5.3%) with SCC, and 73 (2.1%) with melanoma. At 15 years after BMT, the test model AUCs were 0.81 (95% CI, 0.76-0.85) for BCC, 0.90 (95% CI, 0.86-0.93) for SCC, and 0.83 (95% CI, 0.74-0.90) for melanoma. The 15-year cumulative incidence of BCC, SCC, and melanoma in the low-risk group was 2.4% (95% CI, 1.5%-3.9%), 3.2% (95% CI, 2.4%-4.2%), and 0.8% (95% CI, 0.4%-1.5%), respectively. In the high-risk group, the 15-year cumulative incidence of BCC, SCC, and melanoma was 13.3% (95% CI, 11.6%-15.4%), 13.6% (95% CI, 11.2%-16.5%), and 4.4% (95% CI, 3.2%-6.1%), respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this prognostic study, risk stratification models demonstrated excellent performance, highlighting potential utility for identifying BMT recipients who are at greatest risk of subsequent cutaneous malignant neoplasms.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.2763","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:00:23Z","timestamp":1786546823000},"page":"998","source":"Crossref","is-referenced-by-count":0,"title":["Risk Stratification Models for Cutaneous Malignant Neoplasms After Blood or Marrow Transplant"],"prefix":"10.1001","volume":"162","author":[{"given":"Kristy K.","family":"Broman","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston"},{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingrui","family":"Meng","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Richman","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"},{"name":"Department of Veterans Affairs, Birmingham VA Medical Center, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Zhou","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Balas","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Landier","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Hageman","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alysia","family":"Bosworth","sequence":"additional","affiliation":[{"name":"Department of Population Sciences, City of Hope, Duarte, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Lennie","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Population Sciences, City of Hope, Duarte, California"},{"name":"Department of Computational and Quantitative Medicine, City of Hope, Duarte, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplantation, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Weisdorf","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saro H.","family":"Armenian","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, City of Hope, Duarte, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"10","key":"doi260033r1","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1016\/j.bbmt.2013.07.020","article-title":"Prevalence of hematopoietic cell transplant survivors in the United States.","volume":"19","author":"Majhail","year":"2013","journal-title":"Biol Blood Marrow Transplant"},{"issue":"9","key":"doi260033r2","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1016\/j.bbmt.2020.03.005","article-title":"Hematopoietic stem cell transplant recipients surviving at least 2 years from transplant have survival rates approaching population levels in the modern era of transplantation.","volume":"26","author":"Kliman","year":"2020","journal-title":"Biol Blood Marrow Transplant"},{"issue":"4","key":"doi260033r3","doi-asserted-by":"publisher","first-page":"614","DOI":"10.3324\/haematol.2016.150250","article-title":"Late effects of blood and marrow transplantation.","volume":"102","author":"Inamoto","year":"2017","journal-title":"Haematologica"},{"issue":"10","key":"doi260033r4","doi-asserted-by":"publisher","first-page":"738","DOI":"10.7326\/0003-4819-131-10-199911160-00004","article-title":"Malignant neoplasms in long-term survivors of bone marrow transplantation.","volume":"131","author":"Kolb","year":"1999","journal-title":"Ann Intern Med"},{"issue":"3","key":"doi260033r5","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1001\/jamadermatol.2024.5129","article-title":"Incidence of and risk factors for cutaneous malignant neoplasms after blood or marrow transplant.","volume":"161","author":"Broman","year":"2025","journal-title":"JAMA Dermatol"},{"key":"doi260033r6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-078378","article-title":"TRIPOD+AI statement: updated guidance for reporting clinical prediction models that use regression or machine learning methods.","volume":"385","author":"Collins","year":"2024","journal-title":"BMJ"},{"issue":"30","key":"doi260033r7","doi-asserted-by":"publisher","first-page":"5381","DOI":"10.1002\/sim.5958","article-title":"Estimating and comparing time-dependent areas under receiver operating characteristic curves for censored event times with competing risks.","volume":"32","author":"Blanche","year":"2013","journal-title":"Stat Med"},{"issue":"5","key":"doi260033r8","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1200\/JCO.2014.56.1373","article-title":"Individual prediction of heart failure among childhood cancer survivors.","volume":"33","author":"Chow","year":"2015","journal-title":"J Clin Oncol"},{"issue":"1","key":"doi260033r9","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1200\/JCO.2017.74.8673","article-title":"Prediction of ischemic heart disease and stroke in survivors of childhood cancer.","volume":"36","author":"Chow","year":"2018","journal-title":"J Clin Oncol"},{"issue":"3","key":"doi260033r10","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1093\/biostatistics\/kxt059","article-title":"Concordance for prognostic models with competing risks.","volume":"15","author":"Wolbers","year":"2014","journal-title":"Biostatistics"},{"issue":"12","key":"doi260033r13","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1111\/tri.13493","article-title":"Predicting skin cancer in organ transplant recipients: development of the SUNTRAC screening tool using data from a multicenter cohort study.","volume":"32","author":"Jambusaria-Pahlajani","year":"2019","journal-title":"Transpl Int"},{"issue":"1","key":"doi260033r14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1001\/jamadermatol.2022.4820","article-title":"External validation of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) in a large European solid organ transplant recipient cohort.","volume":"159","author":"G\u00f3mez-Tom\u00e1s","year":"2023","journal-title":"JAMA Dermatol"},{"issue":"12","key":"doi260033r15","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1001\/jamadermatol.2025.3890","article-title":"Skin cancer surveillance program for solid organ transplant recipients.","volume":"161","author":"Lee","year":"2025","journal-title":"JAMA Dermatol"},{"issue":"7","key":"doi260033r16","doi-asserted-by":"publisher","first-page":"466.e1","DOI":"10.1016\/j.jtct.2023.01.022","article-title":"Comparison of patient and provider practices between bone marrow and solid organ transplantation programs for patient education on increased risk of skin cancer.","volume":"29","author":"Shope","year":"2023","journal-title":"Transplant Cell Ther"},{"issue":"15","key":"doi260033r17","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1001\/jama.2023.3262","article-title":"Skin cancer screening: updated evidence report and systematic review for the US Preventive Services Task Force.","volume":"329","author":"Henrikson","year":"2023","journal-title":"JAMA"},{"issue":"15","key":"doi260033r18","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1001\/jama.2023.3259","article-title":"Skin cancer screening: the importance of identifying high-risk subgroups and the need for US-based population research.","volume":"329","author":"Asgari","year":"2023","journal-title":"JAMA"},{"issue":"5 pt 1","key":"doi260033r19","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/S0190-9622(99)70010-1","article-title":"Screening for malignant melanoma: a cost-effectiveness analysis.","volume":"41","author":"Freedberg","year":"1999","journal-title":"J Am Acad Dermatol"},{"issue":"8","key":"doi260033r20","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1111\/jdv.12921","article-title":"Use of antihypertensive drugs and risk of skin cancer.","volume":"29","author":"Schmidt","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"1","key":"doi260033r21","doi-asserted-by":"publisher","first-page":"13151","DOI":"10.1038\/s41598-020-70078-y","article-title":"25-Hydroxyvitamin D status, vitamin D intake, and skin cancer risk: a systematic review and dose-response meta-analysis of prospective studies.","volume":"10","author":"Mahamat-Saleh","year":"2020","journal-title":"Sci Rep"},{"issue":"8","key":"doi260033r22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0160308","article-title":"Vitamin D intake and risk of skin cancer in US women and men.","volume":"11","author":"Park","year":"2016","journal-title":"PLoS One"},{"issue":"17","key":"doi260033r23","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1056\/NEJMoa1506197","article-title":"A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention.","volume":"373","author":"Chen","year":"2015","journal-title":"N Engl J Med"},{"issue":"4","key":"doi260033r24","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1016\/j.jaad.2023.11.034","article-title":"Effectiveness of acitretin for skin cancer prevention in immunosuppressed and nonimmunosuppressed patients: a retrospective cohort study.","volume":"90","author":"Bhullar","year":"2024","journal-title":"J Am Acad Dermatol"},{"issue":"11","key":"doi260033r25","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1001\/jamadermatol.2025.3238","article-title":"Nicotinamide for skin cancer chemoprevention.","volume":"161","author":"Breglio","year":"2025","journal-title":"JAMA Dermatol"},{"issue":"2","key":"doi260033r26","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1016\/j.jaad.2020.04.160","article-title":"Chemoprevention of keratinocyte carcinoma and actinic keratosis in solid-organ transplant recipients: systematic review and meta-analyses.","volume":"84","author":"Tee","year":"2021","journal-title":"J Am Acad Dermatol"},{"issue":"9","key":"doi260033r27","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1056\/NEJMoa2203086","article-title":"Nicotinamide for skin-cancer chemoprevention in transplant recipients.","volume":"388","author":"Allen","year":"2023","journal-title":"N Engl J Med"},{"issue":"8","key":"doi260033r28","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1002\/cncr.26374","article-title":"Randomized controlled trial of acitretin versus placebo in patients at high-risk for basal cell or squamous cell carcinoma of the skin (North Central Cancer Treatment Group Study 969251).","volume":"118","author":"Kadakia","year":"2012","journal-title":"Cancer"},{"key":"doi260033r11","author":"Chang","year":"2024"},{"key":"doi260033r12","unstructured":"BMTSS skin cancer risk calculator. BMTSS skin cancer. Accessed June 27, 2026. https:\/\/subsequent-neoplasms.shinyapps.io\/BMTSS_RiskCalculator\/"}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2852907\/jamadermatology_broman_2026_oi_260033_1792511076.12052.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:00:47Z","timestamp":1792594847000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2852907"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2026.2763","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,1]]}}}