Melanoma risk and survival among organ transplant recipients

Robbins, Hilary A.; Clarke, Christina A.; Arron, Sarah T.; Tatalovich, Zaria; Kahn, Amy R.; Hernandez, Brenda Y.; Paddock, Lisa; Yanik, Elizabeth L.; Lynch, Charles F.; Kasiske, Bertram L.; Snyder, Jon; Engels, Eric A.

doi:10.1038/jid.2015.312

Back to Previous Page

- Add this to...
- Twitter
- Facebook
- Google Bookmarks
- LinkedIn

Melanoma risk and survival among organ transplant recipients

Published Date:

Aug 13 2015

Publisher's site:

http://dx.doi.org/10.1038/jid.2015.312 New Site Icon

Source:

J Invest Dermatol. 135(11):2657-2665.

[PDF-279.29 KB]

Details:

Personal Authors:

Robbins, Hilary A. ; Clarke, Christina A. ; Arron, Sarah T. ; Tatalovich, Zaria ; Kahn, Amy R. ; ... More ▼

Keywords:

[+]

Pubmed ID:

26270022

Pubmed Central ID:

PMC4640996

Description:

Solid organ transplant recipients, who are medically immunosuppressed to prevent graft rejection, have increased melanoma risk, but risk factors and outcomes are incompletely documented. We evaluated melanoma incidence among 139,991 non-Hispanic white transplants using linked US transplant-cancer registry data (1987-2010). We used standardized incidence ratios (SIRs) to compare incidence with the general population and incidence rate ratios (IRRs) from multivariable Poisson models to assess risk factors. Separately, we compared post-melanoma survival among transplant recipients (n=182) and non-recipients (n=131,358) using multivariable Cox models. Among transplant recipients, risk of invasive melanoma (n=519) was elevated (SIR=2.20, 95% CI 2.01-2.39), especially for regional stage tumors (SIR=4.11, 95% CI 3.27-5.09). Risk of localized tumors was stable over time after transplantation but higher with azathioprine maintenance therapy (IRR=1.35, 95% CI 1.03-1.77). Risk of regional/distant stage tumors peaked within 4 years following transplantation and increased with polyclonal antibody induction therapy (IRR=1.65, 95% CI 1.02-2.67). Melanoma-specific mortality was higher among transplant recipients than non-recipients (hazard ratio 2.98, 95% CI 2.26-3.93). Melanoma exhibits increased incidence and aggressive behavior under transplant-related immunosuppression. Some localized melanomas may result from azathioprine, which acts synergistically with UV radiation, whereas T-cell-depleting induction therapies may promote late-stage tumors. Our findings support sun safety practices and skin screening for transplant recipients.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

Main Document Checksum:

[+]

Supporting Files:

	NIHMS714827-supplement-supplement_1.pdf	application/pdf
	nihms714827.nxml	application/octet-stream
	nihms714827f1.gif	image/gif
	nihms714827f1.jpg	image/jpeg
	nihms714827f2.gif	image/gif
	nihms714827f2.jpg	image/jpeg

No Related Documents.

You May Also Like:

Melanoma Outcomes in Transplant Recipients With Pretransplant Melanoma

Personal Author:

Arron, Sarah T.; Raymond, Amanda K.; Yanik, Elizabeth L.; Castenson, David; McCulloch, Charles E.; Clarke, Christina A.; Paddock, Lisa E.; Niu, Xiaoling; Engels, Eric A.;

Published:

Feb 2016

Source:

Dermatol Surg. 42(2):157-166.

Description:

BACKGROUND : There are limited data on outcomes in transplant recipients with a history of pretransplant melanoma. : OBJECTIVE : To determine whether pretransplant melanoma is associated with differences in survival or posttransplant melanoma risk. :...

File Type:

[PDF - 445.36 KB]
Survival after cancer diagnosis among solid organ transplant recipients in the United States

Personal Author:

D’Arcy, Monica E.; Coghill, Anna E.; Lynch, Charles F.; Koch, Lori; Li, Jie; Pawlish, Karen S.; Morris, Cyllene R.; Rao, Chandrika; Engels, Eric A.;

Published:

January 09 2019

Source:

Cancer. 125(6):933-942

Description:

Purpose: : Transplant recipients have an elevated risk of cancer because of organ rejection immunosuppressive medications, but no study has comprehensively examined associations between transplant status and mortality following a cancer diagnosis. : ...

Public Access
Available on:

March 15, 2020
Association of Antibody Induction Immunosuppression with Cancer After Kidney Transplantation

Personal Author:

Hall, Erin C.; Engels, Eric A.; Pfeiffer, Ruth M.; Segev, Dorry L.;

Published:

May 2015

Source:

Transplantation. 99(5):1051-1057.

Description:

Background : Induction immunosuppression is a mainstay of rejection prevention after transplantation. Studies have suggested a connection between antibody induction agents and cancer development, potentially limiting important immunosuppression proto...

File Type:

[PDF - 200.53 KB]
Cancer Stage at Diagnosis in HIV-infected People and Transplant Recipients

Personal Author:

Shiels, Meredith S.; Copeland, Glenn; Goodman, Marc T.; Harrell, Janna; Lynch, Charles F.; Pawlish, Karen; Pfeiffer, Ruth M.; Engels, Eric A.;

Published:

Mar 04 2015

Source:

Cancer. 121(12):2063-2071.

Description:

Background : It is unknown whether immunosuppression results in more aggressive, advanced stage cancers. As cancer stage is influenced both by tumor biology and medical surveillance, we assessed cancer stage in HIV-infected individuals and solid orga...

File Type:

[PDF - 549.01 KB]
Ultraviolet Radiation Exposure and Its Impact on Skin Cancer Risk

Personal Author:

Watson, Meg; Holman, Dawn M.; Maguire-Eisen, Maryellen;

Published:

Jul 29 2016

Source:

Semin Oncol Nurs. 32(3):241-254.

Description:

Objectives : To review research and evidence-based resources on skin cancer prevention and early detection and their importance for oncology nurses. : Data Sources : Journal articles, federal reports, cancer surveillance data, behavioral surveillance...

File Type:

[PDF - 373.52 KB]