Cancer Risk The Same For Kidney Transplant Recipients, No Matter The Drug

Drugs taken by kidney transplant recipients to prevent organ rejection carry similar risks of cancer, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results suggest that no single medication is to blame for the higher incidence of cancer seen among patients who have undergone transplantation.

Individuals who receive a kidney transplant have an increased risk of developing cancer compared with the general population. Researchers suspected that the increased risk may come from immunosuppressive medications that patients must take long-term to prevent organ rejection. To investigate, Martin Gallagher, MBBS, FRACP (The George Institute for International Health in Australia) and his colleagues studied the incidence of cancer in transplant patients who took part in a randomized clinical trial 20 years ago, looking for any differences in cancer risk associated with different immunosuppressive drugs.

The researchers studied the incidence of cancer among 481 kidney transplant recipients in the Australian Multicentre Trial of Cyclosporine Withdrawal who each received one of three treatment regimens: azathioprine and prednisolone, cyclosporine monotherapy, or cyclosporine monotherapy followed by a switch to azathioprine and prednisolone after three months.

A total of 226 patients in the trial developed at least one cancer. By 20 years post transplant, 27% of patients developed non-skin cancer and 48% of patients developed skin cancer. One type of treatment did not have a greater effect on cancer timing or incidence than another, indicating that the therapies carry similar risks for cancer after kidney transplantation. Read more

Immune Therapy Can Protect Against Or Treat Later Lymphoma

Specially developed immune system cells that target the common Epstein-Barr virus can protect immune-suppressed bone marrow transplant recipients against lymph system disease and cancers that arise from the viral infection, said a group of researchers led by those from Baylor College of Medicine, The Methodist Hospital and Texas Children’s Hospital.

“Therapy with EBV-specific CTLs (cytotoxic lymphocytes) was effective for these patients who were severely immune-compromised, as the cells successfully reached the tumor, multiplied and were able to kill tumor cells” said Dr. Helen Heslop, lead author of the study and professor of pediatrics and medicine and a member of the Center for Cell and Gene therapy at BCM, The Methodist Hospital and Texas Children’s. The cell remained in the body for up to nine years, providing long-term protection.

Patients who undergo the transplants are often immune-suppressed. Because most people have been infected with Epstein-Barr virus, the lack of immune protection makes their lymph system vulnerable to adverse effects of the virus, especially lymphomas that can be traced directly back to the infection.

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