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Sirolimus in renal transplant recipients with malignancies in Germany
BACKGROUND: Renal transplant recipients have an increased cancer risk. The mammalian target of rapamycin inhibitor sirolimus (SRL) has immunosuppressive and antitumour activities but knowledge about its use in recipients with cancer is limited. METHODS: We retrospectively analysed 726 renal allograf...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406058/ https://www.ncbi.nlm.nih.gov/pubmed/34476091 http://dx.doi.org/10.1093/ckj/sfaa262 |
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author | Naik, Marcel G Arns, Wolfgang Budde, Klemens Diekmann, Fritz Eitner, Frank Gwinner, Wilfried Heyne, Nils Jürgensen, Jan Steffen Morath, Christian Riester, Udo Heller, Katharina M Fischereder, Michael |
author_facet | Naik, Marcel G Arns, Wolfgang Budde, Klemens Diekmann, Fritz Eitner, Frank Gwinner, Wilfried Heyne, Nils Jürgensen, Jan Steffen Morath, Christian Riester, Udo Heller, Katharina M Fischereder, Michael |
author_sort | Naik, Marcel G |
collection | PubMed |
description | BACKGROUND: Renal transplant recipients have an increased cancer risk. The mammalian target of rapamycin inhibitor sirolimus (SRL) has immunosuppressive and antitumour activities but knowledge about its use in recipients with cancer is limited. METHODS: We retrospectively analysed 726 renal allograft recipients converted to SRL from 10 German transplant centres. Patient and graft survival were analysed depending on malignancy status prior to conversion and tumour entity. RESULTS: Malignancy before conversion to SRL was reported in 230 patients, with 137 patients having skin cancers and 101 having solid cancers. Cancer occurred 4.6 ± 9.4 (median 3.0) years after transplantation. Basal cell carcinoma, squamous cell carcinoma and Bowen’s disease were the most prevalent skin cancers, while carcinomas of the kidney, colon and breast were the most prevalent solid cancers before conversion. Patients with prior malignancy were older and had better renal function at conversion compared with patients without a history of cancer. After conversion to SRL, cancer incidence rates (IRs) of all tumours were lower compared with rates before conversion. Cancer IRs after conversion were higher in patients with malignancy before conversion compared with those without. Patient survival was worse in patients with solid cancers compared with patients with skin cancers or without malignancies. Biopsy-proven acute rejections in the first year after conversion were less frequent in patients with malignancy compared with those without. Graft survival and renal function in all cancer types were better than in patients converted to SRL without cancers. CONCLUSIONS: Conversion to SRL in patients with a history of cancer is safe regarding renal function and graft survival, while patient survival is largely dependent on tumour entity. |
format | Online Article Text |
id | pubmed-8406058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-84060582021-09-01 Sirolimus in renal transplant recipients with malignancies in Germany Naik, Marcel G Arns, Wolfgang Budde, Klemens Diekmann, Fritz Eitner, Frank Gwinner, Wilfried Heyne, Nils Jürgensen, Jan Steffen Morath, Christian Riester, Udo Heller, Katharina M Fischereder, Michael Clin Kidney J Original Articles BACKGROUND: Renal transplant recipients have an increased cancer risk. The mammalian target of rapamycin inhibitor sirolimus (SRL) has immunosuppressive and antitumour activities but knowledge about its use in recipients with cancer is limited. METHODS: We retrospectively analysed 726 renal allograft recipients converted to SRL from 10 German transplant centres. Patient and graft survival were analysed depending on malignancy status prior to conversion and tumour entity. RESULTS: Malignancy before conversion to SRL was reported in 230 patients, with 137 patients having skin cancers and 101 having solid cancers. Cancer occurred 4.6 ± 9.4 (median 3.0) years after transplantation. Basal cell carcinoma, squamous cell carcinoma and Bowen’s disease were the most prevalent skin cancers, while carcinomas of the kidney, colon and breast were the most prevalent solid cancers before conversion. Patients with prior malignancy were older and had better renal function at conversion compared with patients without a history of cancer. After conversion to SRL, cancer incidence rates (IRs) of all tumours were lower compared with rates before conversion. Cancer IRs after conversion were higher in patients with malignancy before conversion compared with those without. Patient survival was worse in patients with solid cancers compared with patients with skin cancers or without malignancies. Biopsy-proven acute rejections in the first year after conversion were less frequent in patients with malignancy compared with those without. Graft survival and renal function in all cancer types were better than in patients converted to SRL without cancers. CONCLUSIONS: Conversion to SRL in patients with a history of cancer is safe regarding renal function and graft survival, while patient survival is largely dependent on tumour entity. Oxford University Press 2020-12-14 /pmc/articles/PMC8406058/ /pubmed/34476091 http://dx.doi.org/10.1093/ckj/sfaa262 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Articles Naik, Marcel G Arns, Wolfgang Budde, Klemens Diekmann, Fritz Eitner, Frank Gwinner, Wilfried Heyne, Nils Jürgensen, Jan Steffen Morath, Christian Riester, Udo Heller, Katharina M Fischereder, Michael Sirolimus in renal transplant recipients with malignancies in Germany |
title | Sirolimus in renal transplant recipients with malignancies in Germany |
title_full | Sirolimus in renal transplant recipients with malignancies in Germany |
title_fullStr | Sirolimus in renal transplant recipients with malignancies in Germany |
title_full_unstemmed | Sirolimus in renal transplant recipients with malignancies in Germany |
title_short | Sirolimus in renal transplant recipients with malignancies in Germany |
title_sort | sirolimus in renal transplant recipients with malignancies in germany |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406058/ https://www.ncbi.nlm.nih.gov/pubmed/34476091 http://dx.doi.org/10.1093/ckj/sfaa262 |
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