Medical Oncology

, Volume 27, Issue 4, pp 1127–1132

Regression of advanced melanoma upon withdrawal of immunosuppression: case series and literature review

Original Paper

DOI: 10.1007/s12032-009-9348-z

Cite this article as:
Dillon, P., Thomas, N., Sharpless, N. et al. Med Oncol (2010) 27: 1127. doi:10.1007/s12032-009-9348-z


We report two cases of stage IV malignant melanoma arising in patients treated with azathioprine for myasthenia gravis. In both cases, the melanoma metastases regressed upon withdrawal of immunosuppression. One patient remains melanoma free at 10 years, and the second patient experienced an 18-month disease free period. There is one prior case report in the medical literature to support full immune reconstitution for treatment in advanced immunosuppression-related melanoma, and one case series suggesting that transplant patients developing melanoma may benefit from a switch to sirolimus. Virtually, no data exist for the medical management of early stage melanoma in the immunosuppressed patients. We review the limited preclinical data in support of immune reconstitution and the data on immunosuppression as a risk factor for melanoma. We conclude that reduction or withdrawal of immunosuppression may be beneficial in patients with advanced stage melanoma and warrants further consideration in patients with early stage melanoma.


MelanomaImmunosuppressionTransplantAzathioprineMyasthenia gravis

Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • P. Dillon
    • 1
  • N. Thomas
    • 2
  • N. Sharpless
    • 1
  • F. Collichio
    • 1
  1. 1.The Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of DermatologyThe University of North Carolina at Chapel HillChapel HillUSA