Navigation Links
Higher cancer rates found in liver transplant patients receiving cyclosporine for immunosuppression
Date:6/24/2010

Researchers at Erasmus MC University Medical Centre in The Netherlands found that cyclosporine treatment is a significant risk factor for the development of de novo cancer in liver transplant patients. Full details appear in the July issue of Liver Transplantation, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases (AASLD).

The 1-year survival rate after liver transplantation has dramatically increased in the past three decades to more than 80%. In contrast, there has been little improvement in long-term outcomes. Malignancy is one of the major leading causes of late death after liver transplant and is reported to be directly related to the intensity and the cumulative dose of immunosuppression.

Calcineurin inhibitors (CNI) such as cyclosporine (CsA) or tacrolimus (TAC) are the cornerstone of immunosuppressive treatment after transplantation. Several studies have yielded conflicting results about the incidence of de novo cancer between CsA- based and TAC-based regimens. Elucidating the role of different CNI regimens in the occurrence of de novo cancer after liver transplant was the goal of this study.

The Dutch team performed retrospective analyses in 385 liver transplant patients who underwent surgery between 1986 and 2007. Analyzed data included age of recipient at time of transplantation, gender of recipient, primary liver transplant indication, type of primary immunosuppressive therapy, de novo malignancy post transplantation, interval from liver transplant to diagnosis of malignancy, interval from liver transplant or diagnosis of cancer to death and interval from liver transplant to diagnosis of the first acute rejection. All patients were followed until December 2008. The primary endpoint was de novo malignancy, which was defined as the development of cancer other than recurrent primary liver cancer. Of the 385 study participants, 50 (13.0%) patients developed at least one de novo cancer.

The researchers observed that CsA in comparison to TAC treatment is the most important risk factor for de novo malignancy after liver transplant. This higher cancer risk was not, however, found in all CsA treated patients, but CsA specifically enhanced development of de novo cancer in patients transplanted in more recent years (2005-2007), and in younger patients (less than 50 years of age). In addition, CsA treatment particularly resulted in more aggressive types of cancer compared to TAC, with a 1-year survival rate less than 30%.

The reason for the increased cancer rates among CsA recipients is believed to be the fact that from January 2005, CsA dosing based on the conventional C0 level monitoring was replaced by dosing based on C2 level monitoring in all liver transplant patients. As this was the only major change in the CsA treatment in the recent study period, the team concludes that the C2 monitoring strategy was the reason for the increased early de novo cancer risk.

"Strikingly, CsA treated patients transplanted from 2005 on showed a 9.9-fold higher de novo cancer risk in the early phase after liver transplant compared to patients treated with TAC. These data indicate that only the specific CsA treatment used in recent years was associated with a higher risk for early development of de novo cancer," said research team leader Herold Metselaar, M.D., Ph.D. "We also observed that, compared with TAC treated patients, CsA treated patients had a 2.5-times higher risk to develop more aggressive cancer types that do not belong to the non-melanoma skin cancer and post-transplant lymphoproliferative disorder (PTLD) categories, indicating that CsA is not only associated with a higher early de novo cancer risk, but also with cancer types having a worse prognosis."

In this month's editorial, Julie Thompson, M.D., suggests that further study is required, stating, "Metselaar and colleagues draw much-needed attention to concerns regarding overall immunosuppressant exposure and its relationship to long-term outcomes after liver transplantation. These data serve as a call to reassess the aggressiveness of current immunosuppressive regimens as a means of reducing risk from de novo malignancy."


'/>"/>

Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Women with polycystic ovary syndrome have higher BPA blood levels
2. Higher Testosterone Tied to Heart Trouble in Older Men
3. Higher levels of vitamin B6, common amino acid associated with lower risk of lung cancer
4. Higher anxiety, depression among women may have basis in cell signals
5. Uninsured Americans have 50 percent higher odds of dying in hospital from heart attack or stroke
6. Teen automobile crash rates are higher when school starts earlier
7. Lack of private insurance contribute to higher deaths among black heart transplant patients
8. Alcohol-related death rates much higher in deprived areas of England and Wales
9. Suicide Risk May Be Higher in Senior Facilities
10. Higher oxygen levels improve preterm survival, increase risk for eye condition
11. Higher blood pressure found in people living in urban areas
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/23/2017)... ... August 23, 2017 , ... Arizona ... hospitals nationally that earned the designation of High Performing Hospitals by U.S. News ... performing indicates a hospital was significantly better than the national average in a ...
(Date:8/23/2017)... ... August 23, 2017 , ... ... Golden Bridge Awards® - for Risk Management Solution Innovations and Security Solution for ... online platform released in 2017 and its DHS SAFETY Act-designated enterprise security assessment ...
(Date:8/22/2017)... ... August 22, 2017 , ... The ... health is as simple as eating healthy foods. But this well-known piece of ... making insulin, or breaking apart carbohydrates—depends not only on properties of the food ...
(Date:8/22/2017)... ... August 22, 2017 , ... Nurses at Apple Rehab Watch ... Cove, recently received training and certification in Closed Pulse Irrigation™ (CPI) for ... five-star rating from the Centers for Medicare and Medicaid Services, to have a CPI ...
(Date:8/22/2017)... ... August 22, 2017 , ... “Covert ... the creation of published author, Julianne Hale, a consultant for the Intelligence Community. ... counter-terrorism expert focusing on the Near East region. Julianne has written hundreds ...
Breaking Medicine News(10 mins):
(Date:8/7/2017)... Aug. 7, 2017 Insightin Health, provider ... retention, and engagement, announced the selection of ... Product Development, effective as of February 2017. In this ... implementation strategy for our clients. Wood brings with ... consulting and business analytics within the healthcare industry. ...
(Date:8/7/2017)... DUBLIN , Aug. 7, 2017  Endo International ... has reached agreements to resolve virtually all known U.S. ... in discussions to resolve the known remaining U.S. claims ... installment payments beginning in the fourth quarter of 2017 ... part of its second quarter 2017 results, the Company ...
(Date:8/2/2017)... , Aug. 2, 2017 Fenita ... Who as a Pinnacle Lifetime Professional in the ... Account Manager at Turing Pharmaceuticals, AG. Her skills ... and relationship building.                ... than 25 years of experience as a highly ...
Breaking Medicine Technology: