Malignant Tumors Arising De Novo in Immunosuppressed Organ Transplant Recipients

Abstract

SummaryDe novo malignant tumors have been observed throughout the world in 75 chronic survivors of organ transplantation, including 16 of our own patients. The incidence of tumors was approximately 80 times greater than in the average population in a comparable age range. Chronic uremia may have predisposed to the development of some of the tumors, but this has not yet been proved. It seems clear that the predominant etiology was chronic immunosuppression posttransplantation. Forty-four of the patients had epithelial tumors and in 31 the lesions were of mesenchymal origin. On the average the malignancies appeared 29 months after transplantation. Lymphomas showed an unusual predilection for involvement of the central nervous system.

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

“…PTLD represents a wide spectrum of monomorphic and polymorphic lymphoproliferative disorders, and large B cell lymphoma is the most frequent type [3,[29][30][31][32]. PTLDs are often extranodal, with graft, cerebral or digestive involvement [33,34].…”

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

“…[1][2][3][4] The immunocompromised state provides a permissive environment for malignant cells to grow, for an oncogenic virus to infect or reactivate within the host, for chronic antigen stimulation leading to a cytokine-rich milieu, and for impaired immune surveillance imposed by chronic immunosuppression. [5][6][7] With the increasing success of liver transplantation (LTx) and fewer episodes of acute rejection with virtual freedom from chronic rejection, long-term survival rates have improved. [8][9][10][11] In addition, with an aging population, older recipients are also being considered for LTx.…”

“…The cumulative number of years of follow-up is also unknown, and this makes it difficult to calculate the actuarial risk. 2,6,[19][20][21] In this respect, data from single centers with long-term follow-up have become an important source of information for the incidence and nature of de novo cancers, which can then be compared with surveillance epidemiological end results data. Furthermore, these data can be presented as a standard incident ratio (SIR).…”

De novo malignancies after liver transplantation: A major cause of late death

“…An increased incidence of de novo malignancies in immunosuppressed organ transplant recipients was first predicted by Starzl 1 in 1968 and confirmed shortly thereafter. 2,3 Several registry [4][5][6] and single-center reports [7][8][9][10] have clearly shown trends to increased incidences of certain types of posttransplantation de novo malignancies, principally those linked to a viral cause. Estimates of developing de novo malignancies range from 4.1% to 16%, 5,11 depending on the type and demographics of the transplant population, length of follow-up, and the era in which transplantations were performed.…”