Lymphocyte Subsets in Renal Transplant Recipients with de novo Genitourinary Malignancies

Abstract

Introduction: The incidence of genitourinary tumors (GUT) in renal transplant recipients (RTR) is higher than in the general population. We previously reported that CD4 lymphocytopenia is associated with a high incidence of skin cancer in RTR. Here, we investigate whether persistent CD4 T cell lymphopenia is associated with GUT occurrence. Patients and Methods: A total of 433 patients were included in this study. All patients underwent annually systematic lymphocyte subset (CD3, CD4, CD8, CD19) determination by flow cytometry. Results and Conclusion: During the follow-up period, 13 patients developed GUT: 6 patients a prostate adenocarcinoma (incidence 0.06%/year) and 7 patients a renal cell carcinoma (incidence 0.07%/year). The patients with GUT were older than those without. Both groups did not differ in posttransplant duration, dialysis mode and duration, induction regimen, or acute rejection history. No persistent CD4 lymphopenia was observed in the patients with GUT. Although CD4 T cell lymphopenia is associated with skin cancer in long-term RTR, it did not appear to be a risk factor for GUT. This suggests that other factors encountered in the setting of kidney transplantation (e.g., immunosuppressive drugs, end-stage renal failure, etc.) favor the development of GUT in RTR.

Immune Monitoring of Kidney Recipients: Biomarkers to Appreciate Immunosuppression -Associated Complications

“…We previously demonstrated that persistent CD4 + T cell lymphopenia is correlated with enhanced risks of cancers −including skin cancers (Ducloux et al, 1998a), monoclonal gammapathies (Ducloux et al, 1999), lymphomas as well as other non skin cancers such as colon or lung cancers (Ducloux et al, 2002a)−, of opportunistic infections (Ducloux et al, 1998b) and atherosclerotic events (Ducloux et al, 2003) in renal transplant recipients. In contrast, CD4 + T cell lymphopenia seems not to be associated with de novo genitourinary malignancies (Guichard et al, 2008). Moreover, we recently associated CD4 + T cell lymphopenia and renal transplant recipient mortality .…”

CD4 T Lymphopenia, Thymic Function, Homeostatic Proliferation and Late Complications Associated with Kidney Transplantation

“…This persistent CD4 + T cell depletion is also correlated with the increased incidence of opportunistic infections [38] and of atherosclerotic events [39]. On the opposite, CD4 + T cell lymphopenia seems not to be associated with de novo genitourinary malignancies [40]. Recently, we associated prolonged CD4 + T cell lymphopenia and renal transplant recipient mortality [41].…”

Malignome – Vor und nach Nierentransplantation

“…Problematisch ist sicherlich die Definition dieser Risikogruppe. Hier gibt es erste Ansätze mithilfe der flowzytometrischen Bestimmung von Lymphozytensubpopulationen [28]. Untersucht wird hier die Bedeutung der CD4-T-Lymphozyten, die insbesondere beim Auftreten von Tumoren des Urogenitaltraktes vermindert sind.…”