Recurrence of cancer after renal transplantation

Chapman, Jeremy R.; Sheil, A. G. R.; Disney, Alex

doi:10.1016/s0041-1345(00)02698-1

Cited by 62 publications

(35 citation statements)

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“…mancy (26)(27)(28). There are extensive clinical data on the occurrence rate of new cancers in patients who have undergone organ transplantation and resultant immunosuppression.…”

Section: Adaptive and Innate Immunity To Cancer Cellsmentioning

confidence: 99%

Controversies in clinical cancer dormancy

Uhr

Pantel

2011

Proc. Natl. Acad. Sci. U.S.A.

227

161

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Clinical cancer dormancy is defined as an unusually long time between removal of the primary tumor and subsequent relapse in a patient who has been clinically disease-free. The condition is frequently observed in certain carcinomas (e.g., breast cancer), B-cell lymphoma, and melanoma, with relapse occurring 5–25 y later. Clinical data suggest that a majority of breast cancer survivors have cancer cells for decades but can remain clinically cancer-free for their lifetime. Thus, there is a major effort to characterize the molecular mechanisms responsible for inducing tumor cell dormancy using experimental models or studying the early phases of cancer growth in humans. Many molecules and signaling pathways have been characterized and have led to concepts that dominate the field, such as the possible role of innate and adaptive immunity in immune surveillance and initiation and maintenance of dormancy. However, recent clinical data do not support many of these concepts. Several areas need further study to determine their relevance to clinical cancer dormancy. We suggest hypotheses that may contribute to elucidation of the mechanisms underlying the dormant state.

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“…mancy (26)(27)(28). There are extensive clinical data on the occurrence rate of new cancers in patients who have undergone organ transplantation and resultant immunosuppression.…”

Section: Adaptive and Innate Immunity To Cancer Cellsmentioning

confidence: 99%

Controversies in clinical cancer dormancy

Uhr

Pantel

2011

Proc. Natl. Acad. Sci. U.S.A.

227

161

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“…In keeping with their low prevalence, no data on the prevalence of neuroendocrine tumors in all-organ transplanted patients has been reported. Available data indicates that the recurrence rate of cancer in transplanted patients ranges between 5 and 21%, and is strictly related to the lag between cancer remission and kidney transplantation as well as type of tumors, multiple myeloma, breast cancer and kidney cancer showing the higher recurrence rate (6). The suggested lag between cancer remission and eligibility to kidney transplantation varies according to the different guidelines and depends upon to the type of the tumor.…”

Section: Discussionmentioning

confidence: 99%

A patient with MEN1 and end‑stage chronic kidney disease due to Alport syndrome: Decision making on the eligibility of transplantation

et al. 2017

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Abstract. Absence of neoplastic disease in the organ-recipient is required in order to allow organ transplantation. Due to its rarity, no data regarding management of patients with Multiple endocrine neoplasia type 1 (MEN1) and end-stage renal failure candidates for kidney transplantation are available. A 36 year-old man was referred to the present hospital with MEN1, with a neuroendocrine pancreatic tumor and primary hyperparathyroidism and associated Alport syndrome with end stage renal failure. The present study aimed to establish the eligibility of the patient for a kidney transplantation. The neuroendocrine tumor had been treated with duodenopancreatectomy two years earlier and hyperparathyroidism by parathyroidectomy. The review of the literature did not provide data regarding the eligibility for kidney transplantation of patients harboring a neuroendocrine pancreatic tumor in the context of MEN1. Due to the end-stage renal failure, neuroendocrine markers were unreliable and the investigation therefore relied on imaging studies, which were unremarkable. Young age, low-grade tumor, low expression of Ki67, absence of metastatic lymph nodes, onset in the setting of a MEN1 were all positive prognostic factors of the neuroendocrine tumor. Normal serum calcium ruled out persistent primary hyperparathyroidism. Overall, hemodyalisis is known to significantly reduce life expectancy. Benefits of kidney transplantation overcome the risk of neuroendocrine tumor recurrence in a young patient bearing MEN1. IntroductionMultiple endocrine neoplasia type 1 (MEN1), is a rare autosomal dominant disease, linked to a mutation of a tumor suppressor gene encoding for the protein menin. Tumors occur in parathyroids, pancreas and pituitary, with a variable phenotype. Alport syndrome, a recessive X-linked disease is due to mutations of the genes, encoding for the procollagen IV, usually leading to end-stage chronic kidney disease. Neurosensory deafness, abnormally colored retina and misshapen lenses are the other most relevant features of the syndrome. The patient we describe herein was carrying both these rare diseases. The clinical challenge we had to face was to establish the eligibility of the patient to kidney and possibly pancreas transplantation. Case reportWe report on a 36 year-old man affected by MEN1, namely with primary hyperparathyroidism (PHPT) and non-secreting neuroendocrine pancreatic tumor and concomitant Alport syndrome with end-stage chronic kidney disease. At the age of 10, following the diagnosis of Alport syndrome in the mother's lineage, the patient underwent a kidney biopsy which showed a histologic picture of Alport syndrome. Five years later, because of increasing proteinuria, angiotensin converting enzyme inhibitor treatment was started. The renal function progressively deteriorated up to end-stage renal failure and, at the age of 32, hemodialysis was started. The diagnosis of Alport syndrome was confirmed by genetic analysis. Familial PHPT was diagnosed in his father's kindred when the patient was 30 ye...

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“…For SOT recipients with a prior history of malignancy, the recurrence rate of the original tumor is between 3.0 and 5.0%, [7,8] and the incidence of new malignancies other than PTLD is only 1-2% higher when compared with the general population [9]. Excluding PTLD, risk factors for other malignancies after SOT include older age, white race, male gender, past history of cancer and long-term dialysis, and are most commonly carcinomas of the skin, gastrointestinal tract and lung.…”

Section: Immune Dysregulation and Risk Of Malignancies In Solid Organmentioning

confidence: 99%

Post-transplant Immune Function and the Development of Lymphoma

Ma¹,

Jones²

2009

Neoplastic Hematopathology

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Abstract/Scope of Chapter Both hematopoietic stem cell transplantation and solid organ transplantation are associated with short-term and long-term immune deficits that result in an increased risk of disseminated infection and malignancy. Here, we discuss these risk factors and the time-course for the development of post-transplant lymphoproliferative disorders in each transplant type. IntroductionHematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) lead to both transient and prolonged immune dysregulation that results in an increased incidence of malignancy. The causes of increased tumorigenesis following transplantation are complex but the most important factors are declines in immune function due to transplant conditioning regimens and the prolonged use of immunosuppressive agents that lead to the reactivation of chronic viral infections. Over time, these infections can promote outgrowth of virally-infected lymphoid populations that proceed to lymphoma. Defects in T-cell immune surveillance due to immunosuppressant therapy also lead to an increased incidence of other types of cancer. The risk factors for development of post-transplant lymphoproliferative disorders in patients following HSCT and SOT are similar but not identical. Immune Dysregulation, Viral Reactivation and Risk of Malignancies in HSCTHSCT is associated with transient and prolonged defects in hematopoiesis and immune function due to its myeloablative features and because of the damage done to the marrow microenvironment by conditioning regimens that include alkylating agents and total blood irradiation (TBI). Engraftment of hematopoietic elements following a myeloablative HSCT takes several weeks with the return of baseline neutrophil function within 2-4 weeks in most patients. There are however long-standing defects in T-cell immunity in nearly all patients that can last for

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Recurrence of cancer after renal transplantation

Cited by 62 publications

References 1 publication

Controversies in clinical cancer dormancy

Controversies in clinical cancer dormancy

A patient with MEN1 and end‑stage chronic kidney disease due to Alport syndrome: Decision making on the eligibility of transplantation

Post-transplant Immune Function and the Development of Lymphoma

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