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J Invest Dermatol. 2019 Oct 24. pii: S0022-202X(19)33322-6. doi: 10.1016/j.jid.2019.09.016. [Epub ahead of print]

Association between human leukocyte antigen type and keratinocyte carcinoma risk in renal transplant recipients.

Author information

1
Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
2
Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
3
Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
4
MGH Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
5
Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. Electronic address: masgari@partners.org.

Abstract

Keratinocyte carcinoma (KC) defined as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is the most common malignancy among non-Hispanic white (NHW) renal transplant recipients (RTRs). While recent genome-wide association studies reported that the class II human leukocyte antigen (HLA) is associated with KC risk, epidemiologic data on HLA type and KC risk in RTRs is limited. Using an institutional cohort of NHW RTRs transplanted between 1993-2017, we examined the association between pre-transplant molecular HLA types and KC risk. Post-transplant KCs were captured using the International Classification of Diseases codes and validated using pathology reports. Cox proportional hazards regression models were used to estimate hazard ratios (HR) of incident KC, SCC and BCC, adjusting for age, male, history of KC, Charlson comorbidity index, HLA mismatch, transplant type, year of transplant, and the type of immunosuppression. Among 617 subjects (mean age 53 years,67% male), 10% developed post-transplant KC. Multivariable Cox regression analyses showed HLA-DRB1*13 was associated with KC risk (HR 1.84, 95% CI 1.00-3.38) and SCC risk (HR 2.24, 95% CI: 1.12-4.49), while HLA-DRB1*14 (HR 2.81, 95% CI: 1.14-6.91) was associated with BCC risk. Our findings suggest that a subset of RTRs with specific HLA polymorphisms may be at increased KC risk.

KEYWORDS:

HLA; basal cell carcinoma; cutaneous squamous cell carcinoma

PMID:
31669059
DOI:
10.1016/j.jid.2019.09.016

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