Vol 6, No 2 (2010)
Review paper
Published online: 2010-06-25

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Post-transplant cancers

Adam Płużański, Paweł Badurak, Maciej Krzakowski
Onkol. Prak. Klin 2010;6(2):53-61.

Abstract

The progress in transplantology and use of new immunosuppressants improved survival time of patients after transplantation. Malignancies are the main cause of death patients with functioning graft. Skin malignancies other than melanoma are the most frequent neoplasms in patients with kidney and liver transplantations. The highest incidence of malignancies after transplantation is related to potential oncogenic viral infection such as Kaposi`s sarcoma caused by human herpes virus type 8, post-transplant lymphoproliferative disorder caused by Epstein-Barr virus and malignancies probably caused by human papilloma virus or hepatitis B/C virus. Risk of solid tumor incidence according to some investigators is 2-4 times higher than in general population. Lung cancer, gastrointestinal cancers and urinary tract tumors are observed in less than 1% of patients after liver transplantation. The most common malignancies in patients after heart transplantation are lymphomas, lung cancer, urinary tract malignancies and skin neoplasms. Age, high dose of immunosuppressants, life style and egzogenic cancerogenous factors exposure are the main risk factors in patients after organ transplantations. Risk of malignancy after transplantation is higher in case of use calcineurin inhibitors than other agents. Immunosuppressive treatment not only may determine type and frequency of malignancy, but also worsens prognosis independently of clinical stage of niewydoldisease compared to general population. Use of new immunosuppressants with specific antineoplastic activity may reduce the incidence of the neoplasms after organ transplantation.
Onkol. Prak. Klin. 2010; 6, 2: 53-61

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References

  1. Australia and New Zealand Liver Transplant Registry. ANZLTR 19 th report 2008. In Edition Brisbane: Australia and New Zealand Liver Transplant Registry. 2008.
  2. Kirklin JK, Naftel DC, Bourge RC, et al. Evolving trends in risk profiles and causes of death after heart transplantation: a ten-year multi-institutional study. J Thorac Cardiovasc Surg. 2003; 125(4): 881–890.
  3. McDonald S.P., Excell L., Livingston B. Chapter 3: Deaths In. In ANZDATA registry report 2007. Australia and New Zealand Dialysis and Transplant Registry, Edition 2007.
  4. Australia and New Zealand Dialysis and Transplant Registry. 28 th report. 2005.
  5. Serraino D, Piselli P, Busnach G, et al. Immunosuppression and Cancer Study Group. Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe. Eur J Cancer. 2007; 43(14): 2117–2123.
  6. Berg D, Otley C. Skin cancer in organ transplant recipients: Epidemiology, pathogenesis, and management. Journal of the American Academy of Dermatology. 2002; 47(1): 1–17.
  7. Carroll RP, Ramsay HM, Fryer AA, et al. Incidence and prediction of nonmelanoma skin cancer post-renal transplantation: a prospective study in Queensland, Australia. Am J Kidney Dis. 2003; 41(3): 676–683.
  8. Euvrard S, Kanitakis J, Thivolet J, et al. Skin cancers after organ transplantation. N Engl J Med. 2003; 348(17): 1681–1691.
  9. Adami J, Gäbel H, Lindelöf B, et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer. 2003; 89(7): 1221–1227.
  10. Bouwes Bavinck JN, Claas FH, Hardie DR, et al. The risk of skin cancer in renal transplant recipients in Queensland, Australia. A follow-up study. Transplantation. 1996; 61(5): 715–721.
  11. Grulich AE, van Leeuwen MT, Falster MO, et al. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet. 2007; 370(9581): 59–67.
  12. Mbulaiteye SM, Engels EA. Kaposi's sarcoma risk among transplant recipients in the United States (1993-2003). Int J Cancer. 2006; 119(11): 2685–2691.
  13. Opelz G, Döhler B. Lymphomas after solid organ transplantation: a collaborative transplant study report. Am J Transplant. 2004; 4(2): 222–230.
  14. Loren AW, Porter DL, Stadtmauer EA, et al. Post-transplant lymphoproliferative disorder: a review. Bone Marrow Transplant. 2003; 31(3): 145–155.
  15. Ogunbiyi OA, Scholefield JH, Raftery AT, et al. Prevalence of anal human papillomavirus infection and intraepithelial neoplasia in renal allograft recipients. Br J Surg. 1994; 81(3): 365–367.
  16. Kasiske BL, Snyder JJ, Gilbertson DT, et al. Cancer after kidney transplantation in the United States. Am J Transplant. 2004; 4(6): 905–913.
  17. Vajdic CM, McDonald SP, McCredie MRE, et al. Cancer incidence before and after kidney transplantation. JAMA. 2006; 296(23): 2823–2831.
  18. Feng S, Buell JF, Chari RS, et al. Tumors and transplantation: The 2003 Third Annual ASTS State-of-the-Art Winter Symposium. Am J Transplant. 2003; 3(12): 1481–1487.
  19. Wong G, Chapman JR. Cancers after renal transplantation. Transplant Rev (Orlando). 2008; 22(2): 141–149.
  20. Villeneuve PJ, Schaubel DE, Fenton SS, et al. Cancer incidence among Canadian kidney transplant recipients. Am J Transplant. 2007; 7(4): 941–948.
  21. Vamvakas S, Bahner U, Heidland A. Cancer in end-stage renal disease: potential factors involved -editorial-. Am J Nephrol. 1998; 18(2): 89–95.
  22. Kasiske BL, Danpanich E, Danpanich E, et al. Risk factors for cancer in renal transplant recipients. Transplantation. 1999; 68(12): 1859–1864.
  23. Penn I. Evaluation of transplant candidates with pre-existing malignancies. Ann Transplant. 1997; 2(4): 14–17.
  24. Chapman JR, Sheil AG, Disney AP. Recurrence of cancer after renal transplantation. Transplant Proc. 2001; 33(1-2): 1830–1831.
  25. European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. Nephrol. Dial. Transplant. 2002; 17(supl.)(4): 1–67.
  26. Kasiske BL, Vazquez MA, Harmon WE, et al. Recommendations for the outpatient surveillance of renal transplant recipients. American Society of Transplantation. J Am Soc Nephrol. 2000; 11 Suppl 15: S1–86.
  27. Taioli E, Mattucci DA, Palmieri S, et al. A population-based study of cancer incidence in solid organ transplants from donors at various risk of neoplasia. Transplantation. 2007; 83(1): 13–16.
  28. Birkeland SA, Storm HH. Risk for tumor and other disease transmission by transplantation: a population-based study of unrecognized malignancies and other diseases in organ donors. Transplantation. 2002; 74(10): 1409–1413.
  29. Kauffman HM, McBride MA, Delmonico FL. First report of the United Network for Organ Sharing Transplant Tumor Registry: donors with a history of cancer. Transplantation. 2000; 70(12): 1747–1751.
  30. Buell JF, Gross T, Alloway RR, et al. Central nervous system tumors in donors: misdiagnosis carries a high morbidity and mortality. Transplant Proc. 2005; 37(2): 583–584.
  31. Buell JF, Beebe TM, Gross TG, et al. United network for organ sharing publication on scientific registry of transplant recipients central nervous system donor cancer transmission data. Transplantation. 2005; 79(5): 623.
  32. Kauffman HM, McBride MA, Cherikh WS, et al. Transplant tumor registry: donors with central nervous system tumors1. Transplantation. 2002; 73(4): 579–582.
  33. Chui AK, Herbertt K, Wang LS, et al. Risk of tumor transmission in transplantation from donors with primary brain tumors: an Australian and New Zealand registry report. Transplant Proc. 1999; 31(1-2): 1266–1267.
  34. Abu-Elmagd KM, Zak M, Stamos JM, et al. De novo malignancies after intestinal and multivisceral transplantation. Transplantation. 2004; 77(11): 1719–1725.
  35. Delgado M, Fernández R, Paradela M, et al. Development of neoplasms during lung transplantation follow-up. Transplant Proc. 2008; 40(9): 3094–3096.
  36. De Giacomo T, Venuta F, Anile M, et al. Malignancies following lung transplantation. Transplant Proc. 2007; 39(6): 1983–1984.
  37. Trulock EP, Edwards LB, Taylor DO, et al. The Registry of the International Society for Heart and Lung Transplantation: twenty-first official adult heart transplant report--2004. J Heart Lung Transplant. 2004; 23(7): 804–815.
  38. Pierson RN. Lung transplantation: current status and challenges. Transplantation. 2006; 81(12): 1609–1615.
  39. Arcasoy SM, Hersh C, Christie JD, et al. Bronchogenic carcinoma complicating lung transplantation. J Heart Lung Transplant. 2001; 20(10): 1044–1053.
  40. de Perrot M, Wigle DA, Pierre AF, et al. Bronchogenic carcinoma after solid organ transplantation. Ann Thorac Surg. 2003; 75(2): 367–371.
  41. Collins J, Kazerooni EA, Lacomis J, et al. Bronchogenic carcinoma after lung transplantation: frequency, clinical characteristics, and imaging findings. Radiology. 2002; 224(1): 131–138.
  42. Hubbard R, Venn A, Lewis S, et al. Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med. 2000; 161(1): 5–8.
  43. Picard C, Grenet D, Copie-Bergman C, et al. Small-cell lung carcinoma of recipient origin after bilateral lung transplantation for cystic fibrosis. J Heart Lung Transplant. 2006; 25(8): 981–984.
  44. Abrahams NA, Meziane M, Ramalingam P, et al. Incidence of primary neoplasms in explanted lungs: long-term follow-up from 214 lung transplant patients. Transplant Proc. 2004; 36(9): 2808–2811.
  45. Haagsma EB, Hagens VE, Schaapveld M, et al. Increased cancer risk after liver transplantation: a population-based study. J Hepatol. 2001; 34(1): 84–91.
  46. Pruthi J, Medkiff KA, Esrason KT, et al. Analysis of causes of death in liver transplant recipients who survived more than 3 years. Liver Transpl. 2001; 7(9): 811–815.
  47. Herrero JI, Lucena JF, Quiroga J, et al. Liver transplant recipients older than 60 years have lower survival and higher incidence of malignancy. Am J Transplant. 2003; 3(11): 1407–1412.
  48. Benlloch S, Berenguer M, Prieto M, et al. De novo internal neoplasms after liver transplantation: increased risk and aggressive behavior in recent years? Am J Transplant. 2004; 4(4): 596–604.
  49. Herrero JI, Lorenzo M, Quiroga J, et al. De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival. Liver Transpl. 2005; 11(1): 89–97.
  50. Jiménez C, Manrique A, Marqués E, et al. Incidence and risk factors of development of lung tumors after liver transplantation. Transplant Proc. 2005; 37(9): 3970–3972.
  51. Kelly D, Emre S, Guy S, et al. Liver transplant recipients are not at increased risk for nonlymphoid solid organ tumors. Cancer. 1998; 83(6): 1237–1243, doi: 10.1002/(sici)1097-0142(19980915)83:6<1237::aid-cncr25>3.0.co;2-5.
  52. Levy M, Backman L, Husberg B, et al. De novo malignancy following liver transplantation: a single-center study. Transplant Proc. 1993; 25(1 Pt 2): 1397–1399.
  53. De novo tumors after liver transplantation. Seventh Congress of the International Liver Transplantation Society Berlin, Germany, 12.07.2001.
  54. Jain AB, Yee LD, Nalesnik MA, et al. Comparative incidence of de novo nonlymphoid malignancies after liver transplantation under tacrolimus using surveillance epidemiologic end result data. Transplantation. 1998; 66(9): 1193–1200.
  55. Potaris K, Radovancevic B, Thomas CD, et al. Lung cancer after heart transplantation: a 17-year experience. Ann Thorac Surg. 2005; 79(3): 980–983.
  56. Melamed MR, Flehinger BJ, Zaman MB, et al. Screening for early lung cancer. Results of the Memorial Sloan-Kettering study in New York. Chest. 1984; 86(1): 44–53.
  57. Fontana RS, Sanderson DR, Woolner LB, et al. Screening for lung cancer. A critique of the Mayo Lung Project. Cancer. 1991; 67(4 Suppl): 1155–1164.
  58. Kubík A, Polák J. Lung cancer detection. Results of a randomized prospective study in Czechoslovakia. Cancer. 1986; 57(12): 2427–2437.
  59. Goldstein DJ, Williams DL, Oz MC, et al. De novo solid malignancies after cardiac transplantation. Ann Thorac Surg. 1995; 60(6): 1783–1789.
  60. Jensen P, Hansen S, Møller B, et al. Are renal transplant recipients on CsA-based immunosuppressive regimens more likely to develop skin cancer than those on azathioprine and prednisolone? Transplant Proc. 1999; 31(1-2): 1120.
  61. Vilardell J, Oppenheimer F, Talbot-Wright R, et al. Increased risk of malignant tumors in renal transplant recipients receiving cyclosporine. Transplant Proc. 1992; 24(5): 1948.
  62. Glover MT, Deeks JJ, Raftery MJ, et al. Immunosuppression and risk of non-melanoma skin cancer in renal transplant recipients. Lancet. 1997; 349(9049): 398.
  63. Guba M, Graeb C, Jauch KW, et al. Pro- and anti-cancer effects of immunosuppressive agents used in organ transplantation. Transplantation. 2004; 77(12): 1777–1782.
  64. Dantal J, Hourmant M, Cantarovich D, et al. Effect of long-term immunosuppression in kidney-graft recipients on cancer incidence: randomised comparison of two cyclosporin regimens. Lancet. 1998; 351(9103): 623–628.
  65. Webster AC, Woodroffe RC, Taylor RS, et al. Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis and meta-regression of randomised trial data. BMJ. 2005; 331(7520): 810.
  66. David KM, Morris JA, Steffen BJ, et al. Mycophenolate mofetil vs. azathioprine is associated with decreased acute rejection, late acute rejection, and risk for cardiovascular death in renal transplant recipients with pre-transplant diabetes. Clin Transplant. 2005; 19(2): 279–285.
  67. Buell J, Gross T, Woodle E. Malignancy after Transplantation. Transplantation. 2005; 80(Supplement): S254–S264.
  68. Cherikh WS, Kauffman HM, McBride MA, et al. Association of the type of induction immunosuppression with posttransplant lymphoproliferative disorder, graft survival, and patient survival after primary kidney transplantation. Transplantation. 2003; 76(9): 1289–1293.
  69. O'Neill JO, Edwards LB, Taylor DO. Mycophenolate mofetil and risk of developing malignancy after orthotopic heart transplantation: analysis of the transplant registry of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2006; 25(10): 1186–1191.
  70. Végso G, Sebestyén A, Paku S, et al. Antiproliferative and apoptotic effects of mycophenolic acid in human B-cell non-Hodgkin lymphomas. Leuk Res. 2007; 31(7): 1003–1008.
  71. Stracke S, Ramudo L, Keller F, et al. Antiproliferative and overadditive effects of everolimus and mycophenolate mofetil in pancreas and lung cancer cells in vitro. Transplant Proc. 2006; 38(3): 766–770.
  72. Frost P, Shi Y, Hoang B, et al. AKT activity regulates the ability of mTOR inhibitors to prevent angiogenesis and VEGF expression in multiple myeloma cells. Oncogene. 2007; 26(16): 2255–2262.
  73. Di Paolo S, Teutonico A, Ranieri E, et al. Monitoring antitumor efficacy of rapamycin in Kaposi sarcoma. Am J Kidney Dis. 2007; 49(3): 462–470.
  74. Goudar RK, Shi Q, Hjelmeland MD, et al. Combination therapy of inhibitors of epidermal growth factor receptor/vascular endothelial growth factor receptor 2 (AEE788) and the mammalian target of rapamycin (RAD001) offers improved glioblastoma tumor growth inhibition. Mol Cancer Ther. 2005; 4(1): 101–112.
  75. Kahan BD, Yakupoglu YK, Schoenberg L, et al. Low incidence of malignancy among sirolimus/cyclosporine-treated renal transplant recipients. Transplantation. 2005; 80(6): 749–758.
  76. Campistol JM, Eris J, Oberbauer R, et al. Sirolimus therapy after early cyclosporine withdrawal reduces the risk for cancer in adult renal transplantation. J Am Soc Nephrol. 2006; 17(2): 581–589.
  77. Pascual J. Post-transplant lymphoproliferative disorder--the potential of proliferation signal inhibitors. Nephrol Dial Transplant. 2007; 22 Suppl 1: i27–i35.
  78. Evens AM, David KA, Helenowski I, et al. Multicenter analysis of 80 solid organ transplantation recipients with post-transplantation lymphoproliferative disease: outcomes and prognostic factors in the modern era. J Clin Oncol. 2010; 28(6): 1038–1046.
  79. Chapman J.R., Webster A.C. Australia and New Zealand Dialysis and Transplant Registry. 25 th Annual Report. In Edition 2003.
  80. Buell JF, Papaconstantinou HT, Skalow B, et al. De novo colorectal cancer: five-year survival is markedly lower in transplant recipients compared with the general population. Transplant Proc. 2005; 37(2): 960–961.
  81. Buell JF, Hanaway MJ, Trofe J, et al. De novo breast cancer in renal transplant recipients. Transplant Proc. 2002; 34(5): 1778–1779.