Allograft and Overall Survival of Patients with Posttransplant Skin Cancer

Christenson, Leslie J.; Cherikh, Wida S.; Otley, Clark C.; Salasche, Stuart J.; Kauffman, H. Myron

doi:10.1111/j.1524-4725.2010.01848.x

Cited by 11 publications

(9 citation statements)

References 28 publications

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“…The localization of cancer on the head and face may require complex surgical procedures, and the recurrence rate after surgery is increased in comparison to immunocompetent people (20). Death due to metastatic dissemination of SCC is rare, as observed in our cohort (Table 4), and the impact of NMSC on overall transplant related mortality and graft survival is uncertain (21)(22). Incidence rates of noncutaneous cancer in the present study were comparable to those reported in other studies, ranging from 13% at 10 years to 30% after 20 years (1-3).…”

Section: Discussionsupporting

confidence: 80%

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Tessari

Naldi

Boschiero

et al. 2013

American Journal of Transplantation

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Limited data exist about cancer prognosis and the development of second cancers in renal transplant recipients. In a retrospective cohort study on 3537 patients incidence rates of the first and, if any, of a second cancer, and standardized incidence ratios [SIR (95% CI)] were computed. Two hundred and sixty-three (7.5%) patients developed a NMSC, and 253 (7.2%) another type of cancer after a median follow-up of 6.5 and 9.0 years, respectively. A statistically significant excess risk, if compared to an age-and sex-matched reference general population, was observed for Kaposi sarcoma and NMSC, followed by non-Hodgkin lymphoma and carcinoma of cervix uteri; a small number of unusual cancers such as tumors of the salivary glands, small intestine and thyroid also were detected at a level worthy of additional scrutiny. Ten-year survival rate of all noncutaneous cancers was 71.3%, with lower rates for lung carcinoma and non-Hodgkin lymphoma (0% and 41.7%, respectively). Patients with NMSC had an increased risk of developing a second NMSC [SIR 8.3 (7.0-10.0)], and patients with a primary noncutaneous cancer had increased risk of developing a second noncutaneous cancer [SIR 1.8 (1.2-2.8)], if compared to the whole cohort. Our study underscore that the high risk of primary and second cancer in renal transplant recipients, including unusual cancers.

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Section: Discussionsupporting

confidence: 80%

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Tessari

Naldi

Boschiero

et al. 2013

American Journal of Transplantation

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“…The prolonged use of azathioprine has been associated with an increased risk of nonmelanoma skin cancer, which may be explained by a dual mechanism, including an increased DNA damage powered by the interaction between ultraviolet-A radiation and 6-thioguanine, and an impaired DNA repair system [59,60]. The actual implication of nonmelanoma skin cancer, which usually is diagnosed at early stages, on prognosis is a matter of debate [61,62]. In inflammatory bowel disease patients treated with azathioprine, there is a four- to five-fold increased risk of lymphoproliferative disorders, especially in elderly patients, but still lymphoma is a very uncommon malignancy [63].…”

Section: Antimetabolitesmentioning

confidence: 99%

Liver transplantation

Rodríguez‐Perálvarez

Mata

Burroughs

2014

Current Opinion in Organ Transplantation

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Purpose of reviewLong-term survival of liver transplant recipients is threatened by increased rates of de-novo malignancy and recurrence of hepatocellular carcinoma (HCC), both events tightly related to immunosuppression.Recent findingsThere is accumulating evidence linking increased exposure to immunosuppressants and carcinogenesis, particularly concerning calcineurin inhibitors (CNIs), azathioprine and antilymphocyte agents. A recent study including 219 HCC transplanted patients showed that HCC recurrence rates were halved if a minimization of CNIs was applied within the first month after liver transplant. With mammalian target of rapamycin (mTOR) inhibitors as approved immunosuppressants for liver transplant patients, pooled data from several retrospective studies have suggested their possible benefit for reducing HCC recurrence.SummaryRandomized controlled trials with sufficiently long follow-up are needed to evaluate the influence of different immunosuppression protocols in preventing malignancy after LT. Currently, early minimization of CNIs with or without mTOR inhibitors or mycophenolate seems a rational strategy for patients with risk factors for de-novo malignancy or recurrence of HCC after liver transplant. A deeper understanding of the immunological pathways of rejection and cancer would allow for designing more specific and safer drugs, and thus to prevent cancer after liver transplant.

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“…CSA acts by binding to intracellular cyclophilin molecules -preventing the activation of the calcium-dependent phosphatase calcineurin -and inhibits the expression of immune-related cytokines such as IL-2 and IFN-γ (8,9). The use of these agents has been associated with an increased incidence of SCCs in particular primary cSCC, which occur proportionally to the intensity and duration of treatment (10,11). One proposed mechanism underlying the tumor-promoting effect seen with CSA use involves decreased tumor surveillance, which may occur as a result of diminished IL-2 production and systemic immunosuppression (12).…”

Section: Introductionmentioning

confidence: 99%

Cyclosporine A immunosuppression drives catastrophic squamous cell carcinoma through IL-22

Abikhair¹,

Mitsui²,

Yanofsky³

et al. 2016

JCI Insight

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Allograft and Overall Survival of Patients with Posttransplant Skin Cancer

Abstract: Longer early to mid-term allograft and overall survival was seen in patients with NMSC, but long-term survival rates must be examined to determine whether mortality rates increase later for patients with NMSC, as noted in previous studies.

Cited by 11 publications

References 28 publications

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Liver transplantation

Cyclosporine A immunosuppression drives catastrophic squamous cell carcinoma through IL-22

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