“Risk of de novo or secondary cancer after solid organ or allogeneic haematopoietic stem cell transplantation”

Abstract

Solid organ (SOT) and allogeneic haematopoietic stem cell (HSCT) transplant recipients have elevated risk of de novo or secondary cancers. We explored risk factors hereof. Methods Among SOT and HSCT transplanted between January 2004-December 2014, standardized incidence ratio (SIR) of de novo/secondary cancer compared with the Danish population was determined and risk factors identified using Poisson regression. Results During a median of 3.4 (IQR 1.3-6.4) and 2.6 (0.8-5.4) person-years (PY) after SOT and HSCT, a total of 212/1656 (13%) and 75/992 (8%) persons developed cancer; SIR 3.61 (3.0-4.3) and 2.2 (1.6-3.0) resp.). SIR correlated with younger age and was highest for skin and haematological cancers for both types of transplantation. Within the cohort, cancer was associated with older age (adjusted incidence rate ratio >50 vs ≤19 years among SOT and HSCT: 9.4 (3.4-25.7) and 25.4 (5.1-126.0), resp.) and current elevated C reactive protein (CRP) (≥10 vs <10 mg/L: 2.5 (1.8-3.4) and 2.3 (1.4-3.9), resp.), but not with prior cancer nor type of immunosuppressants. Conclusion Rates of de novo or secondary cancers are elevated in both SOT and HSCT compared with the general population and mainly for skin and haematological cancers. Among transplant recipients, older age and current elevated CRP are risk factors.

Cancer Risks in Solid Organ Transplant Recipients: Results from a Comprehensive Analysis of 72 Cohort Studies

“…Supplementary Table S3 provides details of the included studies, which involved e1848068-2 a total of 2,105,122 solid organ transplant recipients and reported 45 types of site-specific cancer. Of them, 52 studies 7,8,75 provided SIRs of multiple cancers of solid organ transplantations (11 for multiple organs, 7,8,[17][18][19][20][21][22][23][24][25] 19 for kidney, [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] 16 for liver, [45][46][47][48][49][50][51][52][53][54][55]75 7 for heart and/or lung [60][61][62][76]…”

Immune Activation, Exhaustion and Senescence Profiles as Possible Predictors of Cancer in Liver Transplanted Patients

“…However, very few data are available on the role of aberrant immune activation in the complex process of cancerogenesis occurring in liver transplanted patients. A previous study suggested no difference in the expression of activated CD8 + CD38 + T cells between patients who developed malignancies and non-cancer patients ( 29 ), but in a Danish cohort of solid organ transplant recipients, older age and elevated levels of C-reactive protein, a circulating marker of inflammation, correlated with a high risk for cancer development ( 30 ). In this study, levels of 16S rDNA and mtDNA, markers of PAMPs and DAMPs respectively, were higher at baseline in LT-PTM than in LT-no-PTM patients and remained higher at tumor onset.…”

Post-transplant malignancies in solid organ recipients: development mechanisms and risk factors

“…Начиная с первых трансплантаций донорских органов был отмечен повышенный риск развития рака различных локализаций у реципиентов солидных органов [1,2,[6][7][8][9][10]. Большинство авторов приходят к заключению, что в течение следующего десятилетия злокачественные новообразования станут ведущей причиной смерти у реципиентов солидных органов [3,4,[11][12][13].…”

“…С учетом неуклонно возрастающего количества трансплантаций солидных органов во всем мире (только за 2020 год в мире выполнено 113 363 трансплантации солидных органов) и постепенного увеличения продолжительности жизни реципиентов донорских органов актуальность изучения злокачественных новообразований будет только возрастать. Вопросы развития онкозаболеваний у этой категории достаточно подробно освещены в иностранной литературе, тогда как отечественных источников мы не нашли [1][2][3][4][5][6][7][8][9][10][11][12][13]30].…”