Reduction of immunosuppression for transplant-associated skin cancer: Rationale and evidence of efficacy

Dermatologic Surgery

Volumn 31, Issue 2, 2005, Pages 163-168

  Otley, Clark C ^a,b   Maragh, Sherry L H ^a  

^a MAYO CLINIC COLLEGE OF MEDICINE   (United States)

^b MAYO CLINIC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CANCER ADJUVANT THERAPY; CANCER RISK; DRUG DOSE REDUCTION; EVIDENCE BASED MEDICINE; IMMUNOSUPPRESSIVE TREATMENT; ORGAN TRANSPLANTATION; PRIORITY JOURNAL; REVIEW; RISK REDUCTION; SKIN CANCER; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; FEMALE; HUMAN; MALE; RANDOMIZED CONTROLLED TRIAL; SKIN TUMOR;

AZATHIOPRINE; CYCLOSPORIN; IMMUNOSUPPRESSIVE AGENT; PREDNISOLONE;

AZATHIOPRINE; CYCLOSPORINE; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; MALE; ORGAN TRANSPLANTATION; PREDNISOLONE; RANDOMIZED CONTROLLED TRIALS; SKIN NEOPLASMS;

EID: 15044345553     PISSN: 10760512     EISSN: None     Source Type: Journal    
DOI: 10.1097/00042728-200502000-00008     Document Type: Review

References (40)

1. Morath C, Mueller M, Goldschmidt H, et al. Malignancy in renal transplantation. J Am Soc Nephrol 2004;15:1582-8.
2. Berg D, Otley CC. Skin cancer in organ transplant recipients: epidemiology, pathogenesis, and management. J Am Acad Dermatol 2002;47:1-17.
3. Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med 2003;348:1681-91.
4. Martinez JC, Otley CC, Stasko T, et al. Defining the clinical course of metastatic skin cancer in organ transplant recipients: a multicenter collaborative study. Arch Dermatol 2003;139:301-6.
5. Veness MJ, Quinn DI, Ong CS, et al. Aggressive cutaneous malignancies following cardiothoracic transplantation: the Australian experience. Cancer 1999;85:1758-64.
6. Sheil AG, Disney AP, Mathew TH, Amiss N. De novo malignancy emerges as a major cause of morbidity and late failure in renal transplantation. Transplant Proc 1993;25:1383-4.
7. Ong CS, Keogh AM, Kossard S, et al. Skin cancer in Australian heart transplant recipients. J Am Acad Dermatol 1999;40:27-34.
8. Soulillou JP, Giral M. Controlling the incidence of infection and malignancy by modifying immunosuppression. Transplantation 2001; 72(12 Suppl):S89-93.
9. Hojo M, Morimoto T, Maluccio M, et al. Cyclosporine induces cancer progression by a cell-autonomous mechanism. Nature 1999;397:530-4.
10. Moore DE, Sik RH, Bilski P, et al. Photochemical sensitization by azathioprine and its metabolites. Part 3. A direct EPR and spin-trapping study of light-induced free radicals from 6-mercaptopurine and its oxidation products. Photochem Photobiol 1994;60:574-81.
11. Dantal J, Hourmant M, Cantarovich D, et al. Effect of long-term immunosuppression in kidney-graft recipients on cancer incidence: randomised comparison of two cyclosporin regimens. Lancet 1998; 351:623-28.
12. Otley CC, Coldiron BM, Stasko T, Goldman GD. Decreased skin cancer after cessation of therapy with transplant-associated immunosuppression. Arch Dermatol 2001;137:459-63.
13. Moloney FJ, Kelly PO, Kay EW, et al. Maintenance versus reduction of immunosuppression in renal transplant recipients with aggressive squamous cell carcinoma. Dermatol Surg 2004;30:674-8.
14. Jensen P, Hansen S, Moller B, et al. Skin cancer in kidney and heart transplant recipients and different long-term immunosuppressive therapy regimens. J Am Acad Dermatol 1999;40:177-86.
15. Glover MT, Deeks JJ, Raftery MJ, et al. Immunosuppression and risk of nonmelanoma skin cancer in renal transplant recipients. Lancet 1997;349:398.
16. Kehinde EO, Petermann A, Morgan JD, et al. Triple therapy and incidence of de novo cancer in renal transplant recipients. Br J Surg 1994;81:985-6.
17. Shuttleworth D, Marks R, Griffin PJ, Salaman JR. Epidermal dysplasia and cyclosporine therapy in renal transplant patients: a comparison with azathioprine. Br J Dermatol 1989;120:551-4.
18. Hiesse C, Rieu P, Kriaa F, et al. Malignancy after renal transplantation: analysis of incidence and risk factors in 1700 patients followed during a 25-year period. Transplant Proc 1997;29:831-3.
19. Ramsay HM, Fryer AA, Reece S, et al. Clinical risk factors associated with nonmelanoma skin cancer in renal transplant recipients. Am J Kidney Dis 2000;36:167-76.
20. Fortina AB, Caforio AL, Piaserico S, et al. Skin cancer in heart transplant recipients: frequency and risk factor analysis. J Heart Lung Transplant 2000;19:249-55.
21. Gjersvik P, Hansen S, Moller B, et al. Are heart transplant recipients more likely to develop skin cancer than kidney transplant recipients? Transpl Int 2000;13Suppl 1:S380-1.
22. Euvrard S, Kanitakis J, Brosshard C, et al. No recurrence of posttransplantation Kaposi's sarcoma three years after renal retransplantation. Transplantation 2002;73:297-9.
23. Penn I. Kaposi's sarcoma in transplant recipients. Transplantation 1997; 64:669.
24. Penn I. Sarcomas in organ allograft recipients. Transplantation 1995; 60:1485-91.
25. Woodle ES, Hanaway M, Buell J, et al. Kaposi sarcoma: an analysis of the US and international experiences from the Israel Penn International Transplant Tumor Registry. Transplant Proc 2001;33: 3660-1.
26. Besnard V, Euvrard S, Kanitakis J, et al. Kaposi's sarcoma after liver transplantation. Dermatology 1996;193:100-4.
27. Duman S, Toz H, Asci G, et al. Successful treatment of posttransplant Kaposi's sarcoma by reduction of immunosuppression. Nephrol Dial Transplant 2002;17:892-6.
28. Friedlander MM, Rubinger D, Rosenbaum E, et al. Temporary regression of Merkel cell carcinoma metastases after cessation of cyclosporin. Transplantation 2002;73:1849-50.
29. Green M. Management of Epstein-Barr virus-induced post-transplant lymphoproliferative disease in recipients of solid organ transplantation. Am J Transplant 2001;1:103-8.
30. Starzl TE, Nalesnik MA, Porter KA, et al. Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy. Lancet 1984;i:583-7.
31. Mozzanica N, Cattaneo A, Fracchiolla N, et al. Posttransplantation cutaneous B-cell lymphoma with monoclonal Epstein-Barr virus infection, responding to acyclovir and reduction in immunosuppression. J Heart Lung Transplant 1997;16:964-8.
32. Hanto DW, Frizzera G, Gajl-Peczalska KJ, et al. Epstein-Barr virus induced B-cell lymphoma after renal transplantation: acyclovir therapy and transition from polyclonal to monoclonal B-cell proliferation. N Engl J Med 1982;306:913-8.
33. Armitage JM, Kormos RL, Stuart S, et al. Posttransplant lymphoproliferative disease in thoracic transplant patients; ten years of cyclosporine-based immunosuppression. J Heart Transplant 1991;10:877-87.
34. Tsai DE, Hardy CL, Tomaszewski JE, et al. Reduction of immunosuppression as initial therapy for posttransplant lymphoproliferative disorder: analysis of prognostic variables and long-term follow-up of 42 patients. Transplantation 2001;71: 1076-88.
35. Opelz G, Henderson R. Incidence of non-Hodgkin's lymphoma in kidney and heart transplant recipients. Lancet 1993;342:1514-6.
36. Aichberger C, Eberl T, Riedmann B, et al. Long-term outcome after switching from cyclosporine-based triple-drug immunosuppression to double therapy at three months. Clin Transplant 1996;10:209-12.
37. Matl I, Lacha J, Simova M, et al. Withdrawal of steroids from triple-drug therapy in kidney transplant patients. Nephrol Dial Transplant 2000;15:1041-5.
38. Mazariegos GV, Reyes J, Marino IR, et al. Weaning of immunosuppression in liver transplant recipients. Transplantation 1997;63: 243-9.
39. Oike F, Yokoi A, Nishimura E, et al. Complete withdrawal of immunosuppression in living donor liver transplantation. Transplant Proc 2002;34:1521.
40. Mazariegos GV, Reyes J, Marino I, et al. Risks and benefits of weaning immunosuppression in liver transplant recipients: long-term follow-up. Transplant Proc 1997;29:1174-7.