What types of cancers are associated with immune suppression in HIV? Lessons from solid organ transplant recipients

Vajdic, Claire M.; Leeuwen, Marina T. van

doi:10.1097/coh.0b013e328319bcd1

Cited by 25 publications

(18 citation statements)

References 55 publications

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“…An excess risk of cancer, compared to an ageand sex-matched reference population, was observed for Kaposi sarcoma and NMSC, followed by non-Hodgkin lymphoma, and cancer of cervix uteri and of thyroid. These cancers, with the exception of thyroid cancer, are also detected in patients with AIDS, thus supporting the role of reduced immune surveillance in pathogenesis (2,3,(23)(24)(25). The increased risk of thyroid cancer in transplanted patients has recently been described in a meta-analysis (4).…”

Section: Discussionmentioning

confidence: 99%

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Tessari

Naldi

Boschiero

et al. 2013

American Journal of Transplantation

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Limited data exist about cancer prognosis and the development of second cancers in renal transplant recipients. In a retrospective cohort study on 3537 patients incidence rates of the first and, if any, of a second cancer, and standardized incidence ratios [SIR (95% CI)] were computed. Two hundred and sixty-three (7.5%) patients developed a NMSC, and 253 (7.2%) another type of cancer after a median follow-up of 6.5 and 9.0 years, respectively. A statistically significant excess risk, if compared to an age-and sex-matched reference general population, was observed for Kaposi sarcoma and NMSC, followed by non-Hodgkin lymphoma and carcinoma of cervix uteri; a small number of unusual cancers such as tumors of the salivary glands, small intestine and thyroid also were detected at a level worthy of additional scrutiny. Ten-year survival rate of all noncutaneous cancers was 71.3%, with lower rates for lung carcinoma and non-Hodgkin lymphoma (0% and 41.7%, respectively). Patients with NMSC had an increased risk of developing a second NMSC [SIR 8.3 (7.0-10.0)], and patients with a primary noncutaneous cancer had increased risk of developing a second noncutaneous cancer [SIR 1.8 (1.2-2.8)], if compared to the whole cohort. Our study underscore that the high risk of primary and second cancer in renal transplant recipients, including unusual cancers.

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Section: Discussionmentioning

confidence: 99%

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Tessari

Naldi

Boschiero

et al. 2013

American Journal of Transplantation

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“…Our results indicate that relative to a CD4 >350 cells/mm 3 , the risk for NADC is higher even for a CD4+ cell count of 201–350 cells/mm 3 ; this risk continues to rise for lower levels of CD4, and the risk for a CD4 count of ≤50 cells/mm 3 is 3.58 (1.22, 10.45) relative to CD4 of >350 cells/mm 3 (p value for trend = 0.0004). An apparent and plausible explanation for the association between lower CD4 levels and NADC is that cancer immune surveillance may be impaired in people with lower CD4 cells [28]. …”

Section: Discussionmentioning

confidence: 99%

Incidence of Non-AIDS-Defining Cancer in Antiretroviral Treatment-Naïve Subjects after Antiretroviral Treatment Initiation: An ACTG Longitudinal Linked Randomized Trials Analysis

et al. 2011

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Background: Prospective data on factors associated with the non-AIDS-defining cancer (NADC) incidence in HIV-infected individuals are limited. Methods: We examined the NADC incidence in 3,158 antiretroviral treatment (ART)-naïve subjects after ART initiation in AIDS Clinical Trials Group trials; extended follow-up was available for 2,122 subjects. Poisson regression was used to examine the associations between covariates and incident NADC. Results: At ART initiation, subjects (median age 37 years) were 40% non-Hispanic whites, and 82% were male; 23% had CD4+ T cell count ≤50 cells/mm³ and 25% had CD4 >350 cells/mm³. Median follow-up was 3.8 years. Among 64 incident NADCs, the most common were 8 anal cancers, 8 basal cell carcinomas, 8 Hodgkin’s disease, and 6 lung cancers. In univariate models, age, smoking and recent (time-updated) CD4 were associated with incident NADC. There was no association between initial ART drug class (protease inhibitor, nucleoside reverse transcriptase inhibitor and nonnucleoside reverse transcriptase inhibitor) and NADC. After adjusting for age, race and sex: smoking [relative risk = 2.12 (95% CI = 1.1–4.08)] and recent CD4 (≤50 cells/mm³: 3.58, 1.22–10.45; 51–200 cells/mm³: 2.54, 1.30–5.0; 201–350 cells/mm³: 2.37, 1.32–4.26 vs. >350 cells/mm³) were associated with NADC. Conclusion: Smoking and lower recent CD4 levels, but not initial ART drug class, were associated with NADC. Strategies for maintaining higher CD4 cell counts and successful smoking cessation may reduce the NADC incidence in the HIV-infected population.

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“…Over the last several decades, however, the established link between immunosuppression and tumorigenic viruses in patients with human immunodeficiency virus infection has renewed support for the role of immune surveillance in the containment of neoplasms. 1 These observations have been further underscored by the increased incidence of malignancies in solid organ transplant patients on chronic immunosuppression. However, an infectious etiology has not yet been identified in some of these post-transplant secondary malignancies, 2 suggesting that tumor immunity might not be restricted to neoplasms, which develop secondary to infection by a foreign pathogen.…”

mentioning

confidence: 96%

HLA homozygosity and haplotype bias among patients with chronic lymphocytic leukemia: implications for disease control by physiological immune surveillance

et al. 2011

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What types of cancers are associated with immune suppression in HIV? Lessons from solid organ transplant recipients

Cited by 25 publications

References 55 publications

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

Incidence of Non-AIDS-Defining Cancer in Antiretroviral Treatment-Naïve Subjects after Antiretroviral Treatment Initiation: An ACTG Longitudinal Linked Randomized Trials Analysis

HLA homozygosity and haplotype bias among patients with chronic lymphocytic leukemia: implications for disease control by physiological immune surveillance

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