Cancers Complicating Organ Transplantation

Penn, Israel

doi:10.1056/nejm199012203232510

Cited by 500 publications

(231 citation statements)

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“…The increased incidence of DN post-LT is thought to be due to the depression of the immune system, viral and opportunistic infections, genetic predisposition, and possibly immunosuppression itself [18]. The most important triggering factor for DN development is probably longterm exposure to immunosuppressant agents [19]. We observed that as survival after LT increased, so did the cumulative risk of developing DN, which supports this theory.…”

Section: Discussionsupporting

confidence: 75%

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Evolution and management of de novo neoplasm post-liver transplantation: a 20-year experience from a single European centre

et al. 2010

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Purpose Survival post-liver transplantation (LT) has improved; however, patients are considered at the, risk of malignancy due to prolonged immunosuppression. The long-term outcome of patients developing de novo neoplasm (DN) at our centre was evaluated. Methods Between October 1988 and December 2007, 800 LT were performed in 742 patients. Patients were divided into two study periods according to the time of LT; first: October 1988-December 1995; second: January 1996-December 2007.Results After a mean follow-up of 5 ± 4.6 years, 71 DN (9.5%) were detected in 742 patients. The cumulative risk of DN development increased with the time from LT although no differences at 3, 5, and 10 years were found when first and second periods were compared (3, 7, 16% vs. 2, 4, 11%, respectively; p = 0.4). DN incidence was higher in the first compared with the second period (10.7 vs. 7.8%; p \ 0.04); no significant differences were observed in mortality rate (50 vs. 27%; p = 0.052). Actuarial patient survival post-DN at 1, 3, and 5 years: 67, 48, 45% versus 82, 71, 65%, in the first versus second period, respectively, p \ 0.04.Conclusions DN incidence has decreased in recent years; however, as survival post-LT increases, so does the incidence of DN. Surveillance programmes are necessary to diagnose DN at early stages.

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Section: Discussionsupporting

confidence: 75%

“…In the general non-transplanted population, advanced age usually carries an increased risk for specific tumor development; however, the transplanted population developing DN is younger than the general population [19].…”

Section: Discussionmentioning

confidence: 99%

Evolution and management of de novo neoplasm post-liver transplantation: a 20-year experience from a single European centre

et al. 2010

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“…degree of immunosuppression, and studies have shown that up to 10% of patients with combined heart and lung transplantation may develop PTLD (12), whereas only 1% of patients with renal transplantation develop PTLD. In addition, patients receiving anti-CD3 monoclonal antibodies treatment have also been shown to have an increased risk of PTLD (13). On the other hand, it has been speculated that early reduction of cyclosporin-A dosage may reduce the subsequent risk of PTLD development (13).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, patients receiving anti-CD3 monoclonal antibodies treatment have also been shown to have an increased risk of PTLD (13). On the other hand, it has been speculated that early reduction of cyclosporin-A dosage may reduce the subsequent risk of PTLD development (13). The role EBV plays in the pathogenesis of PTLD is not fully understood, but virtually all PTLD are EBV-related.…”

Section: Discussionmentioning

confidence: 99%

Microsatellite Analysis in Post-Transplantation Lymphoproliferative Disorder to Determine Donor/Recipient Origin

Shek

Thung

et al. 2000

Modern Pathology

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Post-transplantation lymphoproliferative disorders (PTLD) are a group of heterogeneous diseases that occur after organ transplantation. Determination of the origin of the tumor cells not only provides clues to its possible pathogenetic mechanism, but also gives prognostic guidance in the clinical management of patients. We reviewed the clinicopathological features of four cases of PTLD that developed after solid organ transplantation. Using microsatellite analysis performed on paraffin-embedded tissue and using multiple, highly polymorphic markers, we have successfully determined the recipient/ donor origin of the tumor cells in all of them. The time of onset of the PTLD ranged from 5 to 11 mo. All cases were diffuse large cell lymphomas of B-cell lineage, and the two cases that have been tested for EBV by in situ hybridization were positive. Three of the 4 PTLD were of donor origin and these three patients died of diseases unrelated to PTLD. The single patient with PTLD of recipient origin died of disseminated PTLD. The mean survival length of the three patients with donor origin was 26.3 mo, whereas that of the patient with recipient origin was 12 mo. Our results indicate a relatively high incidence of PTLD of donor origin among our patients with solid organ transplantation, as compared to other reported series. Moreover, the finding of the relatively indolent nature of PTLD of donor origin supports that determination of the donor/recipient origin of PTLD is of prognostic significance.KEY WORDS: Donor/recipient origin, Microsatellite analysis, Post-transplantation lymphoproliferative disorder.

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“…Patients with genetically determined immunosuppression, as well as patients iatrogenically immunosuppressed after organ transplantation, have an incidence of NHL and of other lymphoid neoplasias 30 to 50-fold higher than that observed in the general population (Kinlen, 1982;Penn, 1983).…”

mentioning

confidence: 99%

The epidemiology of AIDS-associated non-Hodgkin's lymphoma in the World Health Organization European Region

Serraino

Salamina²,

Franceschi³

et al. 1992

Br J Cancer

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Summary This paper describes the epidemiology of AIDS-associated non-Hodgkin's lymphoma (NHL) in the World Health Organization (WHO) European Region. Data, collected by the WHO Collaborating Centre on AIDS in Paris, France, were derived from the national AIDS surveillance systems of 21 countries. Among 53,042 cases reported as of the end of June 1991, 1,617 (3.0%) had NHL as the presenting clinical manifestation of AIDS. The proportion of cases presenting with NHL ranged from 1.1% in children infected perinatally to 3.9% among haemophiliacs. In comparison with intravenous drug users (IVDUs) (2.6% of whom had NHL), a moderate excess was found among homosexual or bisexual men (odds ratio -OR -:1.2, 95% confidence interval -CI -:1.0-1.3). Over time, the proportion of NHL was constant, but whereas among homosexual or bisexual men the frequency of NHL as AIDS-indicator disease significantly increased (9.7% per year), among IVDUs a significant downward trend emerged (17.1 % per year). In respect to age, two peaks of NHL were seen at the age groups 10-19 (3.8%) and 50-59 (4.3%). The proportion of AIDS-associated NHL significantly increased with increasing age among homosexual and bisexual men and heterosexuals whereas it decreased among IVDUs. All these differences, however, have to be interpreted cautiously on account of the limitations of the reporting systems.

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Cancers Complicating Organ Transplantation

Cited by 500 publications

References 3 publications

Evolution and management of de novo neoplasm post-liver transplantation: a 20-year experience from a single European centre

Evolution and management of de novo neoplasm post-liver transplantation: a 20-year experience from a single European centre

Microsatellite Analysis in Post-Transplantation Lymphoproliferative Disorder to Determine Donor/Recipient Origin

The epidemiology of AIDS-associated non-Hodgkin's lymphoma in the World Health Organization European Region

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