Solid tumors following kidney transplantation in children.
2013 Dec
Journal Article
Authors:
Smith, J.M.;
Martz, K.;
McDonald, R.A.;
Harmon, W.E.
Secondary:
Pediatr Transplant
Volume:
17
Pagination:
726-30
Issue:
8
PMID:
24164825
Keywords:
Carcinoma, Renal Cell; Child; Female; Humans; Immunosuppression; Kidney Failure, Chronic; kidney transplantation; Male; Neoplasms; North America; pediatrics; Registries; Retrospective Studies; Risk Factors; SEER Program
Abstract:
Kidney transplant recipients have an increased risk of cancer. Data on non-LPD malignancies (solid tumors) in pediatric renal transplant recipients are limited. We performed a cohort study using the NAPRTCS transplant registry to describe the incidence of non-LPD malignancy compared with the general pediatric population. The observed incidence rate of non-LPD malignancy in the NAPRTCS transplant registry was 72.1 per 100,000 person-years (SIR 6.7; 95% CI, 5.3, 8.5); a 6.7-fold increased risk compared with the general pediatric population (10.7 cases per 100,000 person-years). Non-LPD malignancy was diagnosed in 35 subjects at a median of 726 days post-transplant. The most common type of malignancy was renal cell carcinoma. The increased risk of non-LPD malignancy was seen in all patients regardless of age, gender, race, etiology of end-stage kidney disease, and transplant era. The specific type of immunosuppression was not identified as a risk factor. In this first large-scale study of North American pediatric renal transplant recipients, we observed a 6.7-fold increased risk of non-LPD malignancy compared with the general pediatric population. Further examination of this unique patient population may provide greater insight into the impact of transplant and immunosuppression on malignancy risk.
