Format

Send to:

Choose Destination
See comment in PubMed Commons below
Transplantation. 2014 Apr 27;97(8):817-25. doi: 10.1097/01.TP.0000442773.38510.32.

Acute rejection, T-cell-depleting antibodies, and cancer after transplantation.

Author information

  • 11 Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. 2 Sydney School of Public Health, University of Sydney, New South Wales, Australia. 3 Centre for Transplant and Renal Research, Westmead Hospital, New South Wales, Australia. 4 Department of Medicine, Queen Mary Hospital, Hong Kong. 5 Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia. 6 Address correspondence to: Wai H. Lim, MBBS, PhD, FRACP, Department of Renal Medicine, Sir Charles Gairdner Hospital, Hospital Avenue, Perth, Australia 6009.

Abstract

BACKGROUND:

Systemic inflammatory response has been shown to play a vital role in carcinogenesis and tumor progression. Acute rejection is a systemic inflammatory state and may share a common casual pathway for cancer development after transplantation. The increased burden of immunosuppression used in the treatment of acute rejection, particularly the use of T-cell-depleting antibody may further heighten the risk of cancer development. We aimed to determine the association between acute rejection, T-cell-depleting antibody use and cancer risk after kidney transplantation.

METHODS:

Using the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), we assessed the risk of incident cancer among those who had experienced rejection stratified by the use of T-cell-depleting antibody using adjusted Cox proportional hazard and competing risk models.

RESULTS:

A total of 7153 kidney transplant recipients between 1997 and 2009 were included. A total of 467 (6.5%) recipients developed cancers. Recipients who experienced acute rejection and treated with T-cell-depleting antibody were at a 1.4-fold increased risk of cancer (adjusted hazard ratio [HR] 1.42, 95% CI 1.02-1.99, P=0.039) compared with those who did not experience acute rejection. There was an excess risk of genitourinary tract cancers among recipients who had experienced rejection requiring T-cell-depleting antibody compared with recipients who did not experience acute rejection (HR 2.20, 95% CI 1.33-3.66, P=0.007).

CONCLUSION:

Acute rejection requiring T-cell-depleting antibody is a significant risk factor for cancer development in kidney transplant recipients independent of competing events such as age and cardiovascular deaths.

PMID:
24521777
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk