An exceptional 18-year follow-up after cardiac transplantation. How can malignancies occur during immunosuppressive therapy?
The present report considers the autopsic study of an homograft recipient who had been living for 18.5 years after a cardiac transplantation. The patient was treated by immunosuppressive therapy associating azathioprine and steroids. During the exceptionally long follow-up, two skin carcinomas and a lung carcinoma occurred successively. In addition, the autopsy allowed observation of a kidney adenocarcinoma associated to a polycystic disease, and a liver regenerative nodular hyperplasia containing several areas of severe dysplasia. These findings, when compared with those usually observed in immunodeficient patients, suggested the possibility that long-term immunosuppressive therapy may give rise to malignancies other than those arising after a short therapy.
Xerri
L
L
Laboratoire d'Anatomie Pathologique, Faculté de Médecine Timone, Marseille, France.
Payan
M J
MJ
Choux
R
R
Gros
N
N
Hassoun
J
J
Chamlian
A
A
Blin
D
D
Monties
J R
JR
D000231:Adenocarcinoma, Papillary / Q000209:etiology; D001379:Azathioprine / Q000009:adverse effects; D002280:Basal Cell Carcinoma / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000209:etiology; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D006965:Hyperplasia / Q000209:etiology; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000209:etiology; D008099:Liver / Q000473:pathology; D008175:Lung Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000209:etiology*; D011241:Prednisone / Q000009:adverse effects; D012878:Skin Neoplasms / Q000209:etiology; D013997:Time Factors
D001379:Azathioprine; D011241:Prednisone