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Immunosuppressive therapy in the posttransplant period and skin cancer
Author(s) -
Krásová Martina,
Sečníková Zuzana,
Göpfertová Dana,
Hercogová Jana,
Viklický Ondřej,
Jůzlová Kateřina,
Jiráková Anna,
Šmerhovský Zdeněk
Publication year - 2016
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.12379
Subject(s) - medicine , skin cancer , cohort , population , incidence (geometry) , immunosuppression , standardized mortality ratio , cancer , tacrolimus , cancer registry , oncology , dermatology , surgery , transplantation , gastroenterology , optics , physics , environmental health
Aims 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. Materials and 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). Conclusion . 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.