Klin Onkol 1998; 11(1): 18-20.
Summary: The incidence of cancers developing in renal transplant recipients with immunosuppressive therapy to prevent rejection of their renal allografts is significantly higher than in the general population. The authors report a group of renal transplant patients who had developed cancer. Since 1972, 556 renal transplantations have been performed due to different causes of end stage renal disease. Patients with de novo malignancies after transplantation have been registered at the lime of diagnosis and followed-up closely with regard to treatment and clinical course of their neoplasms. The average age of patients al the lime of renal transplantation was 43 years. All patients received cadaver kidneys, secondary transplantation was performed in two patients. Four patients received azathioprine with prednisone as conventional immunosuppression, another 10 patients received cyclosporine with prednisone, or azathioprine. Charts of these patients were reviewed lo ascertain each patient's age and sex, type of immunosuppressive agent type of developed cancer, interval from transplantation lo diagnosis of cancer, treatment and survival of patients with malignancy. Fourteen (2.5 %) patients (10 males, four females) had developed malignancies 74.2 months after transplaniation on average. Six patients had epithelial skin cancer (5 of them had basal cell carcinomas, squamous-cell carcinoma was diagnosed in one), cancer of stomach was found in one patient (1), bladder cancer (1), colon and rectum cancer (1), thyroid cancer (1), renal cell carcinoma (1), breast carcinoma (1), chronic leukemia (1), carcinoma of larynx (1). The average survival of patients with malignancy was 14.5 months. Five patients have died of intercurrent disease, four patients died of progressive malignant disease. Five patients are alive without evidence of malignant disease with well functioning graft 24 months on average, following the diagnosis of malignancy. In one patient, malignancy was found al autopsy. In patients surviving along time after kidney transplantation, the possibility of development of malignant disease should be considered. Preventive evaluation should guarantee early detection of malignancy. Appropriate treatment, without terminating immunosuppressive therapy, is indicated with the intention to prolong the lives of patients with a functioning kidney graft.
