Skip to main content

Malignancies Before and After Transplantation

  • Chapter
  • First Online:
  • 1880 Accesses

Abstract

The success of solid organ transplantation has improved dramatically over the past decades in large part due to the potency of immunosuppressive regimens. However, these regimens, with their prolonged depression of the recipient immune response, may also enhance reactivation of latent malignancy, enhance the development of de novo malignancy and, though rare, support the inadvertent transmission of malignancy from donor to recipient. Compared to the general population, the chronic use of immunosuppressive agents increases the long-term risk of malignancy. Additionally, end-stage renal disease, in and of itself, confers an increased risk of malignancy.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Vajdic CM, McDonald SP, McCredie MR et al. Cancer incidence before and after kidney transplantation. JAMA 2006;296:2823–2831.

    Article  CAS  PubMed  Google Scholar 

  2. Webster AC, Craig JC, Simpson JM, Jones MP, Chapman JR. Identifying high risk groups and quantifying absolute risk of cancer after kidney transplantation: a cohort study of 15,183 recipients. Am J Transplant 2007;7:2140–2151.

    Article  CAS  PubMed  Google Scholar 

  3. Maisonneuve P, Agodoa L, Gellert R et al. Cancer in patients on dialysis for end-stage renal disease: an international collaborative study. Lancet 1999;354:93–99.

    Article  CAS  PubMed  Google Scholar 

  4. Webster AC, Hayen A, Kelly PJ, Chapman JR, Craig JC. Impact of kidney transplantation and cancer co-morbidity compared with cancer alone on expected survival: a registry analysis from Australia and New Zealand. Transplantation 2008;86:102–103.

    Article  Google Scholar 

  5. Kauffman HM, Cherikh WS, McBride MA, Cheng Y, Hanto DW. Post-transplant de novo malignancies in renal transplant recipients: the past and present. Transpl Int 2006;19:607–620.

    Article  PubMed  Google Scholar 

  6. Webster AC, Wong G, Craig JC, Chapman JR. Managing cancer risk and decision making after kidney transplantation. Am J Transplant 2008;8:2185–2191.

    Article  CAS  PubMed  Google Scholar 

  7. Adami J, Gabel H, Lindelof B et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer 2003;89:1221–1227.

    Article  CAS  PubMed  Google Scholar 

  8. Chapman JR, Webster AC. Cancer after renal transplantation: the next challenge. Am J Transplant 2004;4:841–842.

    Article  PubMed  Google Scholar 

  9. Mihalov ML, Gattuso P, Abraham K, Holmes EW, Reddy V. Incidence of post-transplant malignancy among 674 solid-organ-transplant recipients at a single center. Clin Transplant 1996;10:248–255.

    CAS  PubMed  Google Scholar 

  10. Bustami RT, Ojo AO, Wolfe RA et al. Immunosuppression and the risk of post-transplant malignancy among cadaveric first kidney transplant recipients. Am J Transplant 2004;4:87–93.

    Article  PubMed  Google Scholar 

  11. Buell JFBT, Woodle ES. Management of Posttransplant Malignancies. Online CME/CE Activity. 2004; http://www.medscape.com/viewprogram/3282_pnt.

  12. Webster AC, Byrne B, McDonald S, Craig JC, Chapman JR. Incidence, risk and prediction of cancer after renal transplantation; an analysis of ANZDATA, the Australian and New Zealand Dialysis & Transplant Registry. Transplantation 2004;78:35.

    Article  Google Scholar 

  13. Shapiro R, Nalesnik M, McCauley J et al. Posttransplant lymphoproliferative disorders in adult and pediatric renal transplant patients receiving tacrolimus-based immunosuppression. Transplantation 1999;68:1851–1854.

    Article  CAS  PubMed  Google Scholar 

  14. Ulrich C, Kanitakis J, Stockfleth E, Euvrard S. Skin cancer in organ transplant recipients – where do we stand today? Am J Transplant 2008;8:2192–2198.

    Article  CAS  PubMed  Google Scholar 

  15. Lebbe C, Euvrard S, Barrou B et al. Sirolimus conversion for patients with posttransplant Kaposi’s sarcoma. Am J Transplant 2006;6:2164–2168.

    Article  CAS  PubMed  Google Scholar 

  16. Tessmer CS, Magalhaes LV, Keitel E et al. Conversion to sirolimus in renal transplant recipients with skin cancer. Transplantation 2006;82:1792–1793.

    Article  PubMed  Google Scholar 

  17. Fernandez A, Marcen R, Pascual J et al. Conversion from calcineurin inhibitors to everolimus in kidney transplant recipients with malignant neoplasia. Transplant Proc 2006;38:2453–2455.

    Article  CAS  PubMed  Google Scholar 

  18. Monaco AP. The role of mTOR inhibitors in the management of posttransplant malignancy. Transplantation 2009;87:157–163.

    Article  CAS  PubMed  Google Scholar 

  19. Buell JF, Gross TG, Woodle ES. Malignancy after transplantation. Transplantation 2005;80:S254–S264.

    Article  PubMed  Google Scholar 

  20. Engl T, Makarevic J, Relja B et al. Mycophenolate mofetil modulates adhesion receptors of the beta1 integrin family on tumor cells: impact on tumor recurrence and malignancy. BMC Cancer 2005;5:4.

    Article  PubMed  Google Scholar 

  21. Robson R, Cecka JM, Opelz G, Budde M, Sacks S. Prospective registry-based observational cohort study of the long-term risk of malignancies in renal transplant patients treated with mycophenolate mofetil. Am J Transplant 2005;5:2954–2960.

    Article  CAS  PubMed  Google Scholar 

  22. 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;25:1186–1191.

    Article  PubMed  Google Scholar 

  23. Feng H, Shuda M, Chang Y, Moore PS. Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science 2008;319:1096–1100.

    Article  CAS  PubMed  Google Scholar 

  24. Boxman IL, Berkhout RJ, Mulder LH et al. Detection of human papillomavirus DNA in plucked hairs from renal transplant recipients and healthy volunteers. J Invest Dermatol 1997;108:712–715.

    Article  CAS  PubMed  Google Scholar 

  25. Berkhout RJ, Bouwes Bavinck JN, ter Schegget J. Persistence of human papillomavirus DNA in benign and (pre)malignant skin lesions from renal transplant recipients. J Clin Microbiol 2000;38:2087–2096.

    CAS  PubMed  Google Scholar 

  26. Harwood CA, Surentheran T, McGregor JM et al. Human papillomavirus infection and non-melanoma skin cancer in immunosuppressed and immunocompetent individuals. J Med Virol 2000;61:289–297.

    Article  CAS  PubMed  Google Scholar 

  27. Arends MJ, Benton EC, McLaren KM, Stark LA, Hunter JA, Bird CC. Renal allograft recipients with high susceptibility to cutaneous malignancy have an increased prevalence of human papillomavirus DNA in skin tumours and a greater risk of anogenital malignancy. Br J Cancer 1997;75:722–728.

    CAS  PubMed  Google Scholar 

  28. Meyer T, Arndt R, Nindl I, Ulrich C, Christophers E, Stockfleth E. Association of human papillomavirus infections with cutaneous tumors in immunosuppressed patients. Transpl Int 2003;16:146–153.

    Article  PubMed  Google Scholar 

  29. Euvrard S, Chardonnet Y, Pouteil-Noble C et al. Association of skin malignancies with various and multiple carcinogenic and noncarcinogenic human papillomaviruses in renal transplant recipients. Cancer 1993;72:2198–2206.

    Article  CAS  PubMed  Google Scholar 

  30. Euvrard S, Chardonnet Y, Pouteil-Noble CP, Kanitakis J, Thivolet J, Touraine JL. Skin malignancies and human papillomaviruses in renal transplant recipients. Transplant Proc 1993;25:1392–1393.

    CAS  PubMed  Google Scholar 

  31. de Jong-Tieben LM, Berkhout RJ, ter Schegget J et al. The prevalence of human papillomavirus DNA in benign keratotic skin lesions of renal transplant recipients with and without a history of skin cancer is equally high: a clinical study to assess risk factors for keratotic skin lesions and skin cancer. Transplantation 2000;69:44–49.

    Article  PubMed  Google Scholar 

  32. Wong G, Webster AC, Chapman JR, Craig JC. Reported cancer screening practices of nephrologists: results from a national survey. Nephrol Dial Transplant 2009;24(7):2136–2143.

    Article  PubMed  Google Scholar 

  33. Wong G, Chapman JR, Craig JC. Cancer screening in renal transplant recipients: what is the evidence? Clin J Am Soc Nephrol 2008;3(Suppl 2):S87–S100.

    Article  PubMed  Google Scholar 

  34. 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;74:1409–1413.

    Article  PubMed  Google Scholar 

  35. Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med 2003;348:1681–1691.

    Article  PubMed  Google Scholar 

  36. Kasiske BL, Snyder JJ, Gilbertson DT, Wang C. Cancer after kidney transplantation in the United States. Am J Transplant 2004;4:905–913.

    Article  PubMed  Google Scholar 

  37. Ramsay HM, Reece SM, Fryer AA, Smith AG, Harden PN. Seven-year prospective study of nonmelanoma skin cancer incidence in U.K. renal transplant recipients. Transplantation 2007;84:437–439.

    Article  PubMed  Google Scholar 

  38. Bordea C, Wojnarowska F, Millard PR, Doll H, Welsh K, Morris PJ. Skin cancers in renal-transplant recipients occur more frequently than previously recognized in a temperate climate. Transplantation 2004;77:574–579.

    Article  CAS  PubMed  Google Scholar 

  39. 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;17:581–589.

    Article  CAS  PubMed  Google Scholar 

  40. Otley CC, Maragh SL. Reduction of immunosuppression for transplant-associated skin cancer: rationale and evidence of efficacy. Dermatol Surg 2005;31:163–168.

    Article  CAS  PubMed  Google Scholar 

  41. 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;351:623–628.

    Article  CAS  PubMed  Google Scholar 

  42. O’Donovan P, Perrett CM, Zhang X et al. Azathioprine and UVA light generate mutagenic oxidative DNA damage. Science 2005;309:1871–1874.

    Article  PubMed  Google Scholar 

  43. Otley CC, Cherikh WS, Salasche SJ, McBride MA, Christenson LJ, Kauffman HM. Skin cancer in organ transplant recipients: effect of pretransplant end-organ disease. J Am Acad Dermatol 2005;53:783–790.

    Article  PubMed  Google Scholar 

  44. Walker RC. Pretransplant assessment of the risk for posttransplant lymphoproliferative disorder. Transplant Proc 1995;27:41.

    CAS  PubMed  Google Scholar 

  45. Opelz G, Henderson R. Incidence of non-Hodgkin lymphoma in kidney and heart transplant recipients. Lancet 1993;342:1514–1516.

    Article  CAS  PubMed  Google Scholar 

  46. Kirk AD, Cherikh WS, Ring M et al. Dissociation of depletional induction and posttransplant lymphoproliferative disease in kidney recipients treated with alemtuzumab. Am J Transplant 2007;7:2619–2625.

    Article  CAS  PubMed  Google Scholar 

  47. Humar A, Hebert D, Davies HD, Stephens D, O’Doherty B, Allen U. A randomized trial of ganciclovir versus ganciclovir plus immune globulin for prophylaxis against Epstein-Barr virus related posttransplant lymphoproliferative disorder. Transplantation 2006;81:856–861.

    Article  CAS  PubMed  Google Scholar 

  48. Funch DP, Walker AM, Schneider G, Ziyadeh NJ, Pescovitz MD. Ganciclovir and acyclovir reduce the risk of post-transplant lymphoproliferative disorder in renal transplant recipients. Am J Transplant 2005;5:2894–2900.

    Article  CAS  PubMed  Google Scholar 

  49. Trappe R, Riess H, Babel N et al. Salvage chemotherapy for refractory and relapsed posttransplant lymphoproliferative disorders (PTLD) after treatment with single-agent rituximab. Transplantation 2007;83:912–918.

    Article  CAS  PubMed  Google Scholar 

  50. Leblond V, Dhedin N, Mamzer Bruneel MF et al. Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders. J Clin Oncol 2001;19:772–778.

    CAS  PubMed  Google Scholar 

  51. Trofe J, Buell JF, Beebe TM et al. Analysis of factors that influence survival with post-transplant lymphoproliferative disorder in renal transplant recipients: the Israel Penn International Transplant Tumor Registry experience. Am J Transplant 2005;5:775–780.

    Article  PubMed  Google Scholar 

  52. Ghobrial IM, Habermann TM, Maurer MJ et al. Prognostic analysis for survival in adult solid organ transplant recipients with post-transplantation lymphoproliferative disorders. J Clin Oncol 2005;23:7574–7582.

    Article  PubMed  Google Scholar 

  53. Johnson SR, Cherikh WS, Kauffman HM, Pavlakis M, Hanto DW. Retransplantation after post-transplant lymphoproliferative disorders: an OPTN/UNOS database analysis. Am J Transplant 2006;6:2743–2749.

    Article  CAS  PubMed  Google Scholar 

  54. Doublet JD, Peraldi MN, Gattegno B, Thibault P, Sraer JD. Renal cell carcinoma of native kidneys: prospective study of 129 renal transplant patients. J Urol 1997;158:42–44.

    Article  CAS  PubMed  Google Scholar 

  55. Denton MD, Magee CC, Ovuworie C et al. Prevalence of renal cell carcinoma in patients with ESRD pre-transplantation: a pathologic analysis. Kidney Int 2002;61:2201–2209.

    Article  PubMed  Google Scholar 

  56. Brennan JF, Stilmant MM, Babayan RK, Siroky MB. Acquired renal cystic disease: implications for the urologist. Br J Urol 1991;67:342–348.

    Article  CAS  PubMed  Google Scholar 

  57. Israel GM, Bosniak MA. An update of the Bosniak renal cyst classification system. Urology 2005;66:484–488.

    Article  PubMed  Google Scholar 

  58. Morath C, Mueller M, Goldschmidt H, Schwenger V, Opelz G, Zeier M. Malignancy in renal transplantation. J Am Soc Nephrol 2004;15:1582–1588.

    Article  PubMed  Google Scholar 

  59. Koutsky LA, Holmes KK, Critchlow CW et al. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. N Engl J Med 1992;327:1272–1278.

    Article  CAS  PubMed  Google Scholar 

  60. The Future II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 2007;356:1915–1927.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Roslyn B. Mannon .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag US

About this chapter

Cite this chapter

Prendergast, M.B., Mannon, R.B. (2010). Malignancies Before and After Transplantation. In: McKay, D., Steinberg, S. (eds) Kidney Transplantation: A Guide to the Care of Kidney Transplant Recipients. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1690-7_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1690-7_18

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-1689-1

  • Online ISBN: 978-1-4419-1690-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics