Gender differences in cancer risk after kidney transplantation
Buxeda, Anna (Hospital del Mar (Barcelona, Catalunya))
Redondo-Pachón, Dolores (Hospital del Mar (Barcelona, Catalunya))
Pérez-Sáez, María José (Hospital del Mar (Barcelona, Catalunya))
Bartolomé-Solanas, Álvaro (Universitat Autònoma de Barcelona. Departament de Medicina)
Mir, Marisa (Hospital del Mar (Barcelona, Catalunya))
Pascual-Dapena, Ana (Universitat Pompeu Fabra. Departament de Ciències Experimentals i de la Salut)
Sans, Anna (Universitat Autònoma de Barcelona. Departament de Medicina)
Duran-Jordà, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Crespo, Marta (Universitat Autònoma de Barcelona. Departament de Medicina)
Pascual Santos, Julio (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2019
Resum:	Kidney transplant (KT) recipients are at greater risk of developing some cancers than the general population. Moreover, cancer is the only cause of death that is currently increasing after kidney transplantation. We analyzed incidence, risk factors and characteristics of post-transplant malignancies (solid organ tumors and lymphoproliferative disorders) at our center in 925 KT recipients (1979-2014). Sex differences were particularly assessed. One hundred and eight patients (11. 7%) developed solid organ tumors (76. 9%) or lymphoma (23. 1%). Twenty-one percent of patients who reached 20 years after KT developed cancer, with a median post-KT time to diagnosis of 7. 4 years. Most common solid organs affected were lung (30. 1%), prostate (10. 8%), bladder (9. 6%), and native kidney (7. 2%). When analyzing standardized incidence ratios (SIR) by gender compared to the general population, relative risk was increased in women (SIR = 1. 81; 95%CI, 1. 28-2. 45) but not significantly increased in men (SIR = 1. 22; 0. 95-2. 52). Regarding specific types, gynecological (SIR = 11. 6; 4. 2-22. 7) and lung (SIR = 10. 0; 4. 3-18. 2) in women, and bladder (SIR = 16. 3; 5. 9-32. 1) in men were the most affected locations. Thymoglobulin, a polyclonal antibody that has been used as an immunosuppressive agent in kidney transplantation over the last decades, was a significant risk factor for developing cancer in adjusted regression analysis [IRR = 1. 62, 1. 02-2. 57; p = 0. 041], and was associated with lower patient survival. Compared with the general population, the incidence of post-KT non-skin cancer is almost two-fold higher in women but not significantly higher in men. Lung is the most common solid organ affected. Thymoglobulin induction therapy is associated with a greater risk.
Ajuts:	Instituto de Salud Carlos III PI16-00619 Instituto de Salud Carlos III RD16-0009-0013
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cancer ; Immunosuppression ; Kidney transplant ; Gender ; Risk factor
Publicat a:	Oncotarget, Vol. 10 (may 2019) , p. 3114-3128, ISSN 1949-2553

DOI: 10.18632/oncotarget.26859
PMID: 31139324

15 p, 4.1 MB

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