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Treatment for presumed BK polyomavirus nephropathy and risk of urinary tract cancers among kidney transplant recipients in the United States
Author(s) -
Gupta Gaurav,
Kuppachi Sarat,
Kalil Roberto S.,
Buck Christopher B.,
Lynch Charles F.,
Engels Eric A.
Publication year - 2018
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14530
Subject(s) - medicine , bk virus , urinary system , renal pelvis , incidence (geometry) , urology , kidney cancer , population , bladder cancer , cancer , kidney transplantation , kidney , oncology , gastroenterology , physics , environmental health , optics
Recent case series describe detection of BK polyomavirus ( BKV ) in urinary tract cancers in kidney transplant recipients, suggesting that BKV could contribute to the development of these cancers. We assessed risk for urinary tract cancers in kidney recipients with or without treatment for presumed BKV nephropathy ( tBKVN ) using data from the United States Transplant Cancer Match Study (2003‐2013). Among 55 697 included recipients, 2015 (3.6%) were reported with tBKVN . Relative to the general population, incidence was similarly elevated (approximately 4.5‐fold) for kidney cancer in recipients with or without tBKVN , and incidence was not increased in either group for prostate cancer. In contrast, for invasive bladder cancer, incidence was more strongly elevated in recipients with versus without tBKVN (standardized incidence ratios 4.5 vs. 1.7; N = 48 cases), corresponding to an incidence rate ratio ( IRR ) of 2.9 (95% confidence interval [CI] 1.0‐8.2), adjusted for sex, age, transplant year, and use of polyclonal antibody induction. As a result, recipients with tBKVN had borderline increased incidence for all urothelial cancers combined (renal pelvis, ureter, and bladder cancers: adjusted IRR 2.2, 95% CI 0.9‐5.4; N = 89 cases). Together with reports describing BKV detection in tumor tissues, these results support an association between BKV and urothelial carcinogenesis among kidney transplant recipients.