Neoplasia in Immunosuppressed Renal Transplant Patients: A 20-Year Experience

Tc, Krueger; Mb, Tallent; Re, Richie; Hk, Johnson; Rc, MacDonell; Turner, Bradley M.

doi:10.1097/00007611-198505000-00002

Cited by 15 publications

(5 citation statements)

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“…In our experience, extrahepatic malignancies were as uncommon in patients receiving azathioprine as in those receiving prednisone alone, and tumor occurrence was unrelated to the cumulative duration of treatment. Additionally, the types of tumors that developed in our patients were different from the predominantly lymphoproliferative and squamous cell malignancies described in association with the administration of azathioprine (19,21,22).…”

Section: Discussioncontrasting

confidence: 55%

“…In humans, however, the validity of the association remains unestablished (20). Lymphomas that have been described in patients have occurred on the background of renal disease, chronic azotemia, transplantation, generalized immunosuppression and high doses of the drug (21,22). Postmortem studies which have indicated a high frequency of extrahepatic malignancy in azathioprinetreated patients with CAH have lacked suitable control populations and administered higher than conventional doses of the medication (15).…”

Section: Discussionmentioning

confidence: 99%

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Extrahepatic malignancy following long-term immunosuppressive therapy of severe hepatitis B surface antigen-negative chronic active hepatitis

et al. 1989

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To determine the frequency, predisposing factors and consequences of extrahepatic malignancy following long-term immunosuppressive therapy of severe HBsAg-negative chronic active hepatitis, 149 patients who had received prednisone (20 mg daily) or prednisone (10 mg daily) in combination with azathioprine (50 mg daily) for at least 6 months were evaluated systematically for 109 +/- 5 months (range: 7 to 223 months). Seven neoplasms involving cervix (2), lymphatic tissue (1), breast (1), bladder (1), soft tissue (1) and unknown site (1) developed in seven patients after 116 +/- 23 months (range: 18 to 164 months). The incidence of extrahepatic neoplasm was 1 per 194 patient-years of surveillance, and the probability of tumor occurrence was 3% after 10 years. Tumor frequency was similar in men and women and the risk was 1.4-fold greater than that in an age- and sex-matched normal population (95% confidence interval, 0.6- to 2.9-fold normal). Patients with extrahepatic malignancy were not distinguished by age, sex, treatment regimen, cumulative duration of treatment (42 +/- 9 vs. 60 +/- 4 months, p = 0.7) or individual features of the liver disease. Five of the seven patients survived during 48 +/- 25 months of follow-up, including two patients who have lived for at least 5 years after the diagnosis of malignancy. We conclude that extrahepatic malignancy develops infrequently during long-term immunosuppressive therapy. Its occurrence is not related to the type or duration of treatment, and long-term survival after tumor detection is possible. The low but probably increased risk of extrahepatic neoplasm does not militate against the use of immunosuppressive therapy in these patients.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Extrahepatic malignancy following long-term immunosuppressive therapy of severe hepatitis B surface antigen-negative chronic active hepatitis

et al. 1989

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“…95 ,266,274 One hepatic allograft recipient even rejected a donor hepatocellular carcinoma and its widespread pulmonaI)' metastases. 152 Unfortunately, this happy outcome is not the rule in most cases. 231 However, it does demonstrate the power of the host immune response to reject foreign cells, even in some cases in which they are fully malignant.…”

Section: Other Neoplasms In Immune Deficient Statesmentioning

confidence: 99%

The diagnosis and treatment of posttransplant lymphoproliferative disorders

Nalesnik

Makowka

Starzl

1988

Current Problems in Surgery

249

111

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“…1 Suppression of the host immune response might be associated with this increased incidence of malignancy. 3 Penn 1 conducted a study on primary kidney tumors before and after renal transplantation, based on the Cincinnati Transplant Tumor Registry (CTTR), which collected data on 8091 de novo tumors that occurred in 7596 recipients. There were 47 cases of renal carcinomas in donor kidneys, 403 cases of preexisting renal carcinomas in recipients, and 256 cases of posttransplant de novo carcinomas in renal allograft recipients, of which 222 involved the patients' own kidney and 24, the allograft (in 10 cases the exact location was not stated).…”

Section: Discussionmentioning

confidence: 99%

Successful Surgical Treatment of Renal Cell Carcinoma in a Transplanted Kidney from a Cadaveric Donor: Report of a Case

Gunji

Sakamoto

Yamada³

et al. 2001

Surgery Today

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Posttransplant renal cell carcinoma (RCC) usually arises in the native kidneys of renal transplant recipients rather than in the transplanted kidney. This report describes a case of RCC that developed in the transplanted cadaveric kidney in a 37-year-old male recipient 9 months after transplantation. An en bloc radical transplant nephrectomy was performed, and he has subsequently remained stable on hemodialysis for 3 years without any sign of recurrence.

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Neoplasia in Immunosuppressed Renal Transplant Patients: A 20-Year Experience

Cited by 15 publications

References 0 publications

Extrahepatic malignancy following long-term immunosuppressive therapy of severe hepatitis B surface antigen-negative chronic active hepatitis

Extrahepatic malignancy following long-term immunosuppressive therapy of severe hepatitis B surface antigen-negative chronic active hepatitis

The diagnosis and treatment of posttransplant lymphoproliferative disorders

Successful Surgical Treatment of Renal Cell Carcinoma in a Transplanted Kidney from a Cadaveric Donor: Report of a Case

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