Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe

Serraino, Diego; Piselli, Pierluca; Busnach, G; Burra, Patrizia; Citterio, Franco; Arbustini, Eloisa; Baccarani, Umberto; Juli, E. De; Pozzetto, U; Bellelli, Stefania; Polesel, Jerry; Pradier, Christian; Maso, Luigino Dal; Angeletti, Claudio; Carrieri, Patrizia; Rezza, Giovanni; Franceschi, Silvia

doi:10.1016/j.ejca.2007.07.015

Cited by 111 publications

(91 citation statements)

References 26 publications

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“…Although no information was available on the site or type of NHL, one death for primary effusion lymphoma is of interest, given the rarity of this HHV8-associated neoplasm among HIV-negative persons . With respect to the nearly 12-fold excess for HL and the 2.2-fold excess for myeloma (borderline significance), again, our findings confirm previous reports (Iscovich et al, 1999b;Cannon et al, 2000;Serraino et al, 2007).…”

Section: Discussionsupporting

confidence: 82%

“…Although direct comparisons are difficult, the pattern of excesses/deficits for cancers in our study showed both similarities and differences when compared with persons with HIV/AIDS and transplant recipients (Grulich et al, 2007;Serraino et al, 2007;Dal Maso et al, 2009). In particular, we found a deficit for all cancers combined, compared with an excess reported for the other populations; lymphoid malignancies showed an excess in both our population and the others.…”

Section: Discussionmentioning

confidence: 87%

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Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

et al. 2009

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BACKGROUND: Little information is available on the causes of death among persons with classic Kaposi's sarcoma (CKS). METHODS: We conducted a population-based study in Italy to identify deceased persons with CKS and the underlying causes of death among them, by reviewing multiple-causes-of-death records. Standardised mortality ratios (SMRs) and 95% confidence intervals were calculated to compare the distribution of causes to that among the same-age general population of deceased persons. The geographical distribution was also evaluated. RESULTS: Of the 946 deaths among persons with CKS, 65.9% were attributable to non-neoplastic conditions and 21.9% to malignancies. For 12.2%, no lethal pathology was identified and CKS was considered as the underlying cause. In 90% of these cases, there was visceral/nodal involvement, therapy-related complications, or neoplastic cachexia. Among persons with CKS who died of other causes, an excess for lymphoid malignancies emerged (SMR ¼ 4.40) (chronic lymphocytic leukaemia (11.03), non-Hodgkin's lymphoma (4.22), Hodgkin's lymphoma (11.80), and multiple myeloma (2.3)), balanced by a deficit for all solid cancers (0.56), with a marked deficit for lung cancer (0.41). We found an excess for respiratory diseases (chronic obstructive pulmonary disease (1.86)) and genitourinary diseases (chronic renal failure (6.47)). There was marked geographical heterogeneity in the distribution of deaths. CONCLUSIONS: Though referring specifically to Italy, the results are informative for other countries and populations and all cases of CKS in general.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 87%

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

et al. 2009

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“…Non-Hodgkin lymphoma replaced KS as the most frequent cancer type and non-AIDS-defining cancers increased from 15 to 25% of all cancers. For the first time a significant excess of liver cancer emerged in the Italian AIDS linkage study (Dal Maso et al, 2003), in agreement with record-linkage studies from the United States Patel et al, 2008) and findings from HIV cohorts in Italy (Serraino et al, 2007) and Switzerland . As PWHA live longer, the appearance of an excess of liver cancer compared with the general population was predictable owing to the high prevalence of hepatitis B and, more notably, hepatitis C infection among PWHA.…”

Section: Discussionsupporting

confidence: 64%

“…The excess risk observed in PWHA was confirmed, however, to be weaker than among transplant recipients (Grulich et al, 2007;Serraino et al, 2007).…”

Section: Discussionmentioning

confidence: 84%

Pattern of cancer risk in persons with AIDS in Italy in the HAART era

et al. 2009

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A record-linkage study was carried out between the Italian AIDS Registry and 24 Italian cancer registries to compare cancer excess among persons with HIV/AIDS (PWHA) before and after the introduction of highly active antiretroviral therapy (HAART) in 1996. Standardised incidence ratios (SIR) were computed in 21951 AIDS cases aged 16 -69 years reported between 1986 and 2005. Of 101 669 person-years available, 45 026 were after 1996. SIR for Kaposi sarcoma (KS) and non-Hodgkin lymphoma greatly decreased in 1997 -2004 compared with 1986 -1996, but high SIRs for KS persisted in the increasingly large fraction of PWHA who had an interval of o1 year between first HIV-positive test and AIDS diagnosis. A significant excess of liver cancer (SIR ¼ 6.4) emerged in 1997 -2004, whereas the SIRs for cancer of the cervix (41.5), anus (44.0), lung (4.1), brain (3.2), skin (non-melanoma, 1.8), Hodgkin lymphoma (20.7), myeloma (3.9), and non-AIDS-defining cancers (2.2) were similarly elevated in the two periods. The excess of some potentially preventable cancers in PWHA suggests that HAART use must be accompanied by cancer-prevention strategies, notably antismoking and cervical cancer screening programmes. Improvements in the timely identification of HIV-positive individuals are also a priority in Italy to avoid the adverse consequences of delayed HAART use.

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“…Of these, 39 were excluded, as they comprised 3 duplicate studies, 2 studies not written in English, 1 review, 21 from which the SIR and 95% CI could not be calculated, 10 studies on hospital-based cohorts and 2 on irrelevant topics. Finally, 22 cohort studies contained in 18 studies were included in the present meta-analysis (8)(9)(10)(11)(12)(13)(14)(15)(16)(22)(23)(24)(25)(26)(27)(28)(29)(30). The main characteristics of the studies included are presented in Table I.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Cancer risk in patients receiving renal replacement therapy: A meta-analysis of cohort studies

Shi

Huang

et al. 2016

Molecular and Clinical Oncology

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Abstract. It has been reported that patients receiving renal replacement therapy (RRT), including dialysis and kidney transplantation, tend to have an increased risk of cancer; however, studies on the degree of this risk have remained inconclusive. The present meta-analysis was therefore performed to quantify the cancer risk in patients with RRT. Cohort studies assessing overall cancer risk in RRT patients published before May 29, 2015 were included following systematic searches with of PubMed, EMBASE and the reference lists of the studies retrieved. Random-effects meta-analyses were used to pool standardized incidence rates (SIRs) with 95% confidence intervals (CIs). Heterogeneity tests, sensitivity analyses and publication bias assessment were performed. A total of 18 studies including 22 cohort studies were eventually identified, which comprised a total of 1,528,719 patients. In comparison with the general population, the pooled SIR for patients with dialysis including non-melanoma skin cancer (NMSC), dialysis excluding NMSC, transplantation including NMSC, transplantation excluding NMSC and RRT were 1.40 (95% CI, 1.36-1.45), 1.35 (95% CI, 1.23-1.50), 3.26 (95% CI, 2.29-4.63), 2.08 (95% CI, 1.73-2.50) and 2.01 (95% CI, 1.70-2.38), respectively. The cancer risk was particularly high in subgroups of large sample size trials, female patients, younger patients (age at first dialysis, 0-34 years; age at transplantation, 0-20 years), the first year of RRT and non-Asian transplant patients. A significant association was also found between RRT and the majority of organ-specific cancers. However, neither dialysis nor transplantation was associated with breast, body of uterus, colorectal or prostate cancer. Significant heterogeneity was found regarding the association between RRT and overall cancer as well as the majority of site-specific cancer types. However, this heterogeneity had no substantial influence on the pooled SIR for overall cancer in RRT according to the sensitivity analysis. Compared with the general population, RRT patients have a significantly increased risk of overall cancer and the majority of specific cancer types, particularly Kaposi sarcoma (KS), lip cancer and NMSC in patients subjected to kidney transplantation and cancer of the thyroid gland and kidney as well as myeloma in dialysis patients. Considering the high heterogeneity encountered, further high-quality studies are required.

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Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe

Cited by 111 publications

References 26 publications

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

Pattern of cancer risk in persons with AIDS in Italy in the HAART era

Cancer risk in patients receiving renal replacement therapy: A meta-analysis of cohort studies

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