Cargando…

Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation

BACKGROUND: Post-transplant malignancy (PTM) causes long-term morbidity and mortality in heart transplant (HTx) recipients. However, the detailed characteristics or predictors of PTM are not well-known. We evaluated the incidence, characteristics, long-term outcomes, and predictors of de novo PTM us...

Descripción completa

Detalles Bibliográficos
Autores principales: Youn, Jong-Chan, Kim, Darae, Kim, In-Cheol, Lee, Hye Sun, Choi, Jin-Oh, Jeon, Eun-Seok, Nishihara, Keith, Kransdorf, Evan P., Chang, David H., Kittleson, Michelle M., Patel, Jignesh K., Ramzy, Danny, Esmailian, Fardad, Kobashigawa, Jon A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393331/
https://www.ncbi.nlm.nih.gov/pubmed/36003907
http://dx.doi.org/10.3389/fcvm.2022.939275
_version_ 1784771249775312896
author Youn, Jong-Chan
Kim, Darae
Kim, In-Cheol
Lee, Hye Sun
Choi, Jin-Oh
Jeon, Eun-Seok
Nishihara, Keith
Kransdorf, Evan P.
Chang, David H.
Kittleson, Michelle M.
Patel, Jignesh K.
Ramzy, Danny
Esmailian, Fardad
Kobashigawa, Jon A.
author_facet Youn, Jong-Chan
Kim, Darae
Kim, In-Cheol
Lee, Hye Sun
Choi, Jin-Oh
Jeon, Eun-Seok
Nishihara, Keith
Kransdorf, Evan P.
Chang, David H.
Kittleson, Michelle M.
Patel, Jignesh K.
Ramzy, Danny
Esmailian, Fardad
Kobashigawa, Jon A.
author_sort Youn, Jong-Chan
collection PubMed
description BACKGROUND: Post-transplant malignancy (PTM) causes long-term morbidity and mortality in heart transplant (HTx) recipients. However, the detailed characteristics or predictors of PTM are not well-known. We evaluated the incidence, characteristics, long-term outcomes, and predictors of de novo PTM using a single center large-volume database. METHODS: We retrospectively analyzed the types and characteristics of de novo PTM in 989 patients who underwent HTx. Univariate and multivariate logistic regression analyses were used for the PTM prediction model. RESULTS: Two hundred and six patients (20.8%) had de novo PTMs (241 cancers) during a median follow-up of 11.5 years. PTM patients were older than non-PTM patients, received immunosuppressive therapy for a longer period, and were more likely to be male and white. Skin cancers were the most frequent types of malignancy (60.6%) followed by prostate (9.5%), lung (7.1%), and breast (4.1%) cancers. Although most cancers (88.8%) were surgically resected at initial presentation, about half (47.3%) recurred or progressed. Patients with skin cancer and non-skin cancer had significantly lower overall survival (P < 0.001) than patients without cancer. Older age (P < 0.001), white race (P = 0.001), and longer time receiving immunosuppressive therapy (P < 0.001) were independent predictors for PTM. CONCLUSION: Older age, white race, and longer administration of immunosuppressive therapies were independent risk factors for PTM, which was associated with increased mortality. Further research is necessary for the prevention and early detection of PTM in HTx recipients.
format Online
Article
Text
id pubmed-9393331
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-93933312022-08-23 Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation Youn, Jong-Chan Kim, Darae Kim, In-Cheol Lee, Hye Sun Choi, Jin-Oh Jeon, Eun-Seok Nishihara, Keith Kransdorf, Evan P. Chang, David H. Kittleson, Michelle M. Patel, Jignesh K. Ramzy, Danny Esmailian, Fardad Kobashigawa, Jon A. Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Post-transplant malignancy (PTM) causes long-term morbidity and mortality in heart transplant (HTx) recipients. However, the detailed characteristics or predictors of PTM are not well-known. We evaluated the incidence, characteristics, long-term outcomes, and predictors of de novo PTM using a single center large-volume database. METHODS: We retrospectively analyzed the types and characteristics of de novo PTM in 989 patients who underwent HTx. Univariate and multivariate logistic regression analyses were used for the PTM prediction model. RESULTS: Two hundred and six patients (20.8%) had de novo PTMs (241 cancers) during a median follow-up of 11.5 years. PTM patients were older than non-PTM patients, received immunosuppressive therapy for a longer period, and were more likely to be male and white. Skin cancers were the most frequent types of malignancy (60.6%) followed by prostate (9.5%), lung (7.1%), and breast (4.1%) cancers. Although most cancers (88.8%) were surgically resected at initial presentation, about half (47.3%) recurred or progressed. Patients with skin cancer and non-skin cancer had significantly lower overall survival (P < 0.001) than patients without cancer. Older age (P < 0.001), white race (P = 0.001), and longer time receiving immunosuppressive therapy (P < 0.001) were independent predictors for PTM. CONCLUSION: Older age, white race, and longer administration of immunosuppressive therapies were independent risk factors for PTM, which was associated with increased mortality. Further research is necessary for the prevention and early detection of PTM in HTx recipients. Frontiers Media S.A. 2022-08-08 /pmc/articles/PMC9393331/ /pubmed/36003907 http://dx.doi.org/10.3389/fcvm.2022.939275 Text en Copyright © 2022 Youn, Kim, Kim, Lee, Choi, Jeon, Nishihara, Kransdorf, Chang, Kittleson, Patel, Ramzy, Esmailian and Kobashigawa. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Youn, Jong-Chan
Kim, Darae
Kim, In-Cheol
Lee, Hye Sun
Choi, Jin-Oh
Jeon, Eun-Seok
Nishihara, Keith
Kransdorf, Evan P.
Chang, David H.
Kittleson, Michelle M.
Patel, Jignesh K.
Ramzy, Danny
Esmailian, Fardad
Kobashigawa, Jon A.
Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
title Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
title_full Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
title_fullStr Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
title_full_unstemmed Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
title_short Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
title_sort characteristics, outcomes, and predictors of de novo malignancy after heart transplantation
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393331/
https://www.ncbi.nlm.nih.gov/pubmed/36003907
http://dx.doi.org/10.3389/fcvm.2022.939275
work_keys_str_mv AT younjongchan characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT kimdarae characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT kimincheol characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT leehyesun characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT choijinoh characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT jeoneunseok characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT nishiharakeith characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT kransdorfevanp characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT changdavidh characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT kittlesonmichellem characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT pateljigneshk characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT ramzydanny characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT esmailianfardad characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation
AT kobashigawajona characteristicsoutcomesandpredictorsofdenovomalignancyafterhearttransplantation