A/Prof. Zaw Thet1,2, Prof Alfred Lam1,3,4, Prof Shu-Kay Ng1, Dr Soe Yu Aung3,6, A/Prof Thin Han2,3, A/Prof Dwarakanathan Ranganathan1,5, Stephanie Newsham2, Jennifer Borg2, Christine Pepito2, A/Prof Tien Khoo1,7
1School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Australia, 2Department of Nephrology, Central Queensland Hospital and Health Service, Australia, 3Faculty of Medicine, University of Queensland, 4700, 4Pathology Queensland, Gold Coast University Hospital, Australia, 5Department of Nephrology, Metro North Hospital and Health Service, Australia, 6Department of Oncology, Central Queensland Hospital and Health Service, Australia, 7School of Medicine, University of Wollongong, Australia
Aims: To compare the risk of non-skin cancers after exposure to immunosuppressants between renal transplant recipients (RTRs) and patients with glomerular disease (GD).
Background: To date, there is no previous comparison on the risk of non-skin cancers between RTRs and patients with GD treated with long-term Immunosuppressants.
Methods: A retrospective cohort study was undertaken among adult RTRs with first-time kidney graft and GD patients in Central and Central West Queensland, Australia.
Results: The cohort comprised of 61 RTRs and 51 GD patients followed up over a median duration of 74.0 months (Interquartile range, IQR 44.5-110.5) and 52.5 months (IQR 29.8-81.8) after exposure to immunosuppressants, respectively (p=0.088). Between two cohorts, no statistical differences were noted between baseline demographics except duration and intensity of immunosuppressants. RTRs were treated with more intense and lengthy immunosuppressive therapy compared to GD patients. 3 renal cell carcinoma (RCC), 2 prostate carcinoma, 2 colorectal carcinoma (CRC), and 1 sarcoma of chest were found in RTRs whereas 2 RCCs and 1 CRC in GD group. The cumulative incidence of solid cancers in RTRs and GD and 11.5% (N=7) and 5.9% (N=3), respectively. One RTR developed post-transplant lymphoproliferative disorder affecting the scalp. No haematological malignancy was reported in GD cohort. The mean age of patients at the time of cancer diagnosis and mean onset of cancer was 47 years (RTRs) vs 67 years (patients with GD), and 133 vs 147 months, respectively.
Conclusions: Immunosuppressants may increase the risk of solid cancers in both cohorts. Higher cancer risk is likely dependent on the intensity and duration of immunosuppressants.
Biography:
He is a full-time nephrologist who specialist interest in immunosuppressant related cancer risk in renal transplant recipients and patients with glomerular diseases.