title: Immunosuppressive therapy in the posttransplant period and skin cancer.
abstract: OBJECTIVE
  To determine the incidence of malignancies in renal transplant recipients (RTRs) and to analyze the association between the risk of skin cancer and immunosuppressive regiments used in the posttransplant period.
  
  
  METHODS
  A cohort study was performed on 797 RTRs. Standardized morbidity ratio (SMR) was calculated for the most common types of cancer developed in the posttransplant period and different types of immunosuppressive therapy used in the cohort.
  
  
  RESULTS
  192 cases of malignancies were diagnosed in 86 RTRs (10.8%). Nonmelanoma skin cancer (NMSC) was the most frequent type of cancer (SMR = 6.42, p = 0.000), followed by renal cancer (SMR = 5.9, p = 0.000), malignant melanoma (SMR = 2.59, p = 0.080), and prostate cancer (SMR = 1.21, p = 0.593). The risk to develop NMSC was significantly higher in the group where cyclosporine has been used besides tacrolimus, mycophenolatemophetil and steroids as well as in the group treated with the combination without cyclosporine (SMR = 9.62, p = 0.001 and SMR = 5.18, p = 0.000). Furthermore, the risk was significantly higher in RTRs receiving anti-thymocyte globulin within induction therapy (SMR = 4.14, p = 0.000).
  
  
  CONCLUSIONS
  The preliminary results indicate that the risk of NMSC in RTRs is significantly higher than in the general population and thus emphasize the need to improve preventive strategies in the Czech transplant population.
authors.affiliation: Dermatology Department, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital.|Institute of Epidemiology, 2nd Medical Faculty, Charles University in Prague.
authors.forename: Martina
authors.initials: M
authors.lastname: Krásová
authors.affiliation: Dermatology Department, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital.|Institute of Epidemiology, 2nd Medical Faculty, Charles University in Prague.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Sečníková
authors.affiliation: Institute of Epidemiology, 2nd Medical Faculty, Charles University in Prague.
authors.forename: Dana
authors.initials: D
authors.lastname: Göpfertová
authors.affiliation: Dermatology Department, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital.
authors.forename: Jana
authors.initials: J
authors.lastname: Hercogová
authors.affiliation: Nephrology Department, Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Ondřej
authors.initials: O
authors.lastname: Viklický
authors.affiliation: Dermatology Department, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital.
authors.forename: Kateřina
authors.initials: K
authors.lastname: Jůzlová
authors.affiliation: Dermatology Department, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital.
authors.forename: Anna
authors.initials: A
authors.lastname: Jiráková
authors.affiliation: Institute of Epidemiology, 2nd Medical Faculty, Charles University in Prague.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Šmerhovský
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018153:Czech Republic; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: immunosuppression; renal transplantation; skin cancer