Lymphocyte subsets in renal transplant recipients with de novo genitourinary malignancies.
BACKGROUND
The incidence of genitourinary tumors (GUT) in renal transplant recipients (RTR) is higher than in the general population. We previously reported that CD4 lymphocytopenia is associated with a high incidence of skin cancer in RTR. Here, we investigate whether persistent CD4 T cell lymphopenia is associated with GUT occurrence.


METHODS
A total of 433 patients were included in this study. All patients underwent annually systematic lymphocyte subset (CD3, CD4, CD8, CD19) determination by flow cytometry.


CONCLUSIONS
During the follow-up period, 13 patients developed GUT: 6 patients a prostate adenocarcinoma (incidence 0.06%/year) and 7 patients a renal cell carcinoma (incidence 0.07%/year). The patients with GUT were older than those without. Both groups did not differ in posttransplant duration, dialysis mode and duration, induction regimen, or acute rejection history. No persistent CD4 lymphopenia was observed in the patients with GUT. Although CD4 T cell lymphopenia is associated with skin cancer in long-term RTR, it did not appear to be a risk factor for GUT. This suggests that other factors encountered in the setting of kidney transplantation (e.g., immunosuppressive drugs, end-stage renal failure, etc.) favor the development of GUT in RTR.
Guichard
Guillaume
G
Department of Urology and Renal Transplantation, University Hospital, Besançon, France.
Rebibou
Jean Michel
JM
Ducloux
Didier
D
Simula-Faivre
Dominique
D
Tiberghien
Pierre
P
Chalopin
Jean Marc
JM
Bittard
Hugues
H
Saas
Philippe
P
Kleinclauss
François
F
D000368:Aged; D015496:CD4-Positive T-Lymphocytes; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008231:Lymphopenia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000097:blood* / Q000209:etiology; D012189:Retrospective Studies; D016176:T-Lymphocyte Subsets; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000209:etiology