title: Cumulative Doses of T-Cell Depleting Antibody and Cancer Risk after Kidney Transplantation.
abstract: T-cell depleting antibody is associated with an increased risk of cancer after kidney transplantation, but a dose-dependent relationship has not been established. This study aimed to determine the association between cumulative doses of T-cell depleting antibody and the risk of cancer after kidney transplantation. Using data from the Australian and New Zealand Dialysis and Transplant Registry between 1997-2012, we assessed the risk of incident cancer and cumulative doses of T-cell depleting antibody using adjusted Cox regression models. Of the 503 kidney transplant recipients with 2835 person-years of follow-up, 276 (55%), 209 (41%) and 18 (4%) patients received T-cell depleting antibody for induction, rejection or induction and rejection respectively. The overall cancer incidence rate was 1,118 cancers per 100,000 patient-years, with 975, 1093 and 1377 cancers per 100,000 patient-years among those who had received 1-5 doses, 6-10 doses and >10 doses, respectively. There was no association between cumulative doses of T cell depleting antibody and risk of incident cancer (1-5: referent, 6-10: adjusted hazard ratio (HR) 1.19, 95%CI 0.48-2.95, >10: HR 1.42, 95%CI 0.50-4.02, p = 0.801). This lack of association is contradictory to our hypothesis and is likely attributed to the low event rates resulting in insufficient power to detect significant differences.
authors.affiliation: Department of Renal Medicine, Prince of Wales Hospital, Sydney, Australia.
authors.forename: Jenny H C
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia.|Sydney School of Public Health, University of Sydney, Sydney, Australia.|Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
authors.forename: Germaine
authors.initials: G
authors.lastname: Wong
authors.affiliation: Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Chapman
authors.affiliation: Sir Charles Gairdner Hospital, Perth, Australia.
authors.forename: Wai H
authors.initials: WH
authors.lastname: Lim
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000009:adverse effects*; D001315:Australia / Q000453:epidemiology; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D016030:Kidney Transplantation; D008212:Lymphocyte Depletion / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D009520:New Zealand / Q000453:epidemiology; D016016:Proportional Hazards Models; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D000961:Antilymphocyte Serum