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

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

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