{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:11:32Z","timestamp":1792793492436,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Second primary malignancies (SPMs) are a well\u2010recognized late complication of allogeneic haematopoietic stem cell transplantation (HSCT). This study aims to evaluate the impact of anti\u2010thymocyte globulin (ATG) and post\u2010transplant cyclophosphamide (PTCy) combination on the incidence of SPMs, compared to other graft\u2010versus\u2010host disease (GvHD) prophylactic regimens. Among 1418 evaluable patients with a median follow\u2010up of 6125 person\u2010years, 138 patients developed an SPM. The cumulative incidence at 5\u2009years was 10.6% (95% CI: 9\u201313). The use of ATG\u2013PTCy was independently associated with a reduced risk of developing SPM (Hazard Ratio [HR], 0.65; <jats:italic>p<\/jats:italic>\u2009=\u20090.02), while older patient age (HR, 1.10; <jats:italic>p<\/jats:italic>\u2009=\u20090.03) and moderate\u2010to\u2010severe chronic GvHD (HR, 1.54; <jats:italic>p<\/jats:italic>\u2009=\u20090.02) were associated with an increased risk of SPM. Compared to the general population, HSCT recipients were 2.45 times more likely to develop a malignancy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The 3\u2010year overall survival from the time of SPM diagnosis was 69.8% (95% CI: 61\u201377) with haematological SPM independently associated with inferior survival (HR: 2.40; 95% CI: 1.3\u20134.5; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Fifteen patients (11%) developed more than one SPM. In conclusion, ATG\u2013PTCy appears to reduce the risk of SPM post\u2010HSCT. Active surveillance and screening for SPMs in transplant survivors are of paramount importance to ensure favourable outcomes.<\/jats:p>","DOI":"10.1111\/bjh.70006","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T10:30:21Z","timestamp":1752921021000},"page":"938-945","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of graft\u2010versus\u2010host disease prophylaxis on second primary malignancies after allogeneic haematopoietic stem cell\u00a0transplantation"],"prefix":"10.1111","volume":"207","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1055-3245","authenticated-orcid":false,"given":"Nihar","family":"Desai","sequence":"first","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshrak","family":"Al\u2010Shaibani","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommy","family":"Alfaro\u2010Moya","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9251-3609","authenticated-orcid":false,"given":"Arjun D.","family":"Law","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Lam","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Remberger","sequence":"additional","affiliation":[{"name":"Department of Haematology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Pasic","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Novitzky\u2010Basso","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auro","family":"Viswabandya","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-4911","authenticated-orcid":false,"given":"Dennis D.","family":"Kim","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Kumar","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H.","family":"Lipton","sequence":"additional","affiliation":[{"name":"Hans Messner Allogeneic Transplant 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