title: Malignancy after renal transplantation in the new era of immunosuppression.
abstract: BACKGROUND
  This retrospective single-center study was undertaken to assess the occurrence of de novo neoplasms in renal transplant recipients according to the immunosuppressive regimen and time after transplantation.
  
  
  METHODS
  Observation encompassed 1028 patients transplanted between the years 1983-2006 and followed for 0.5-23 years. Patients with skin cancer other than melanoma were excluded due to incomplete data collection.
  
  
  RESULTS
  Malignancy appeared in 4.8% (49) of the patients after the period of 5.8 ± 4.7 years at the age of 54 ± 13 years. The most common malignancies were urinary tract tumors (22%) and non-Hodgkin lymphoma with post-transplant lymphoproliferative disease (PTLD) (16%). Malignancy occurred in 5.2% of patients on cyclosporine (CSA), azathioprine (AZA) and prednisone (P); in 3.4% of patients on mofetil mycophenolate (MMF) with CSA and P; in 3.3% of patients on MMF with tacrolimus (TAC) and P; and in 2 of 20 patients (10%) receiving AZA with P 15 years after transplantation. The regimen consisting of CSA, AZA with P could be distinguished by the higher risk of malignancy occurrence. The occurrence of malignancy was significantly earlier on MMF+TAC+P compared to other regimens (p<0.05). The highest incidence of malignancy on AZA with P could be attributed to the longer observation period.
  
  
  CONCLUSIONS
  In the new era of immunosuppression, despite lower occurrence, malignancy tends to appear earlier after the transplantation.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland. ewatorek@wp.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Watorek
authors.forename: Maria
authors.initials: M
authors.lastname: Boratynska
authors.forename: Danuta
authors.initials: D
authors.lastname: Smolska
authors.forename: Dariusz
authors.initials: D
authors.lastname: Patrzalek
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects* / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents