title: Immunosuppression and lung cancer of donor origin after bilateral lung transplantation.
abstract: Analysis of databases from transplant recipients revealed a 3-5 fold higher risk to develop de novo malignancies under continued immunosuppression. The underlying mechanisms are poorly understood. Here we describe a patient who received a bilateral lung transplantation for end-stage 'usual interstitial pneumonia' (UIP) resulting in idiopathic lung fibrosis. The recipient presented with a non-small cell lung carcinoma (NSCLC) in the donor lung 7 months later. Molecular and immunological typing of the tumor revealed a cancer of donor origin with a prominent intratumoral immune cell infiltrate without detectable effector function. This is a unique case of de novo outgrowth of a NSCLC of donor origin under continued immunosuppression, supporting the concept of tumor immunosurveillance in vivo.
authors.affiliation: Medical Oncology, University Hospital Zurich, Switzerland. Lotta.vonBoehmer@usz.ch
authors.forename: Lotta
authors.initials: L
authors.lastname: von Boehmer
authors.forename: Alice
authors.initials: A
authors.lastname: Draenert
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jungraithmayr
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
authors.forename: Schäfer
authors.initials: S
authors.lastname: Niklaus
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
authors.forename: Markus
authors.initials: M
authors.lastname: Hofer
authors.forename: Rolf
authors.initials: R
authors.lastname: Stahel
authors.forename: Alex
authors.initials: A
authors.lastname: Soltermann
authors.forename: Maries
authors.initials: M
authors.lastname: van den Broek
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
authors.forename: Alexander
authors.initials: A
authors.lastname: Knuth
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000628:therapy; D008175:Lung Neoplasms / Q000209:etiology* / Q000473:pathology; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000209:etiology*; D014019:Tissue Donors