title: Epidemiology of de novo malignancies after solid-organ transplantation: immunosuppression, infection and other risk factors.
abstract: Organ transplantation is an increasingly used medical procedure for treating otherwise fatal end-stage organ diseases, and a large number of anti-rejection drugs have been developed to prolong long-term survival of both the individual and the transplanted organ. However, the prolonged use of immunosuppressive drugs is well known to increase the risk of opportunistic diseases, particularly infections and virus-related malignancies. Although transplant recipients experience a nearly twofold elevated risk for all types of de novo cancers, persistent infections with oncogenic viruses are associated with up to hundredfold increased risks. Women of the reproductive age are growing in number among the recipients of solid-organ transplants, but specific data on cancer outcomes are lacking. This article updates evidences linking iatrogenic immunosuppression, persistent infections with oncogenic viruses, other risk factors and post-transplant malignancies. Epidemiological aspects, tumourigenesis related to oncogenic viruses, clinical implications, as well as primary and secondary prevention issues are discussed to offer clinicians and researchers alike an update of an increasingly important topic.
authors.affiliation: National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy. Electronic address: pierluca.piselli@inmi.it.
authors.forename: Pierluca
authors.initials: P
authors.lastname: Piselli
authors.affiliation: National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Verdirosi
authors.affiliation: National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cimaglia
authors.affiliation: Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Ghil
authors.initials: G
authors.lastname: Busnach
authors.affiliation: IRCCS Centro di Riferimento Oncologico, Aviano, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Fratino
authors.affiliation: San Camillo Hospital, Rome, Italy.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
authors.affiliation: IRCCS Centro di Riferimento Oncologico, Aviano, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: De Paoli
authors.affiliation: Catholic University, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Citterio
authors.affiliation: IRCCS Centro di Riferimento Oncologico, Aviano, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
mesh_terms: D002292:Carcinoma, Renal Cell / Q000453:epidemiology; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000453:epidemiology; D008232:Lymphoproliferative Disorders / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D016377:Organ Transplantation; D011247:Pregnancy; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology; D012878:Skin Neoplasms / Q000453:epidemiology; D013997:Time Factors
keywords: Kaposi's sarcoma; cancer risk; iatrogenic immunosuppression; non-Hodgkin lymphoma; oncogenic viruses; solid-organ transplantation