Effect of voriconazole on risk of nonmelanoma skin cancer after hematopoietic cell transplantation

Publication date: Available online 2 August 2017
Source:Journal of the American Academy of Dermatology
Author(s): Lawrence F. Kuklinski, Shufeng Li, Margaret R. Karagas, Wen-Kai Weng, Bernice Y. Kwong
BackgroundVoriconazole has previously been associated with increased risk for cutaneous squamous cell carcinoma (SCC) in solid organ transplant recipients. Less is known about the risk in patients after hematopoietic cell transplantation (HCT).ObjectiveWe evaluated the effect of voriconazole on the risk for nonmelanoma skin cancer (NMSC), including SCC and basal cell carcionoma, among those who have undergone allogeneic and autologous HCT.MethodsIn all, 1220 individuals who had undergone allogeneic HCT and 1418 who had undergone autologous HCT were included in a retrospective cohort study. Multivariate analysis included voriconazole exposure and other known risk factors for NMSC.ResultsIn multivariate analysis, voriconazole use increased the risk for NMSC (hazard ratio, 1.82; 95% confidence interval, 1.13-2.91) among those who had undergone allogeneic HCT, particularly for SCC (hazard ratio, 2.25; 95% confidence interval, 1.30-3.89). Voriconazole use did not appear to confer increased risk for NMSC among those who had undergone autologous HCT.LimitationsThis is a retrospective study.ConclusionVoriconazole use represents an independent factor that may contribute to increased risk specifically for SCC in the allogeneic HCT population.



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