Epidemiology of de novo malignancies after solid-organ transplantation: Immunosuppression, infection and other risk factors

Pierluca Piselli, Diana Verdirosi, Claudia Cimaglia, Ghil Busnach, Lucia Fratino, Giuseppe Maria Ettorre, Paolo De Paoli, Franco Citterio, Diego Serraino

Research output: Contribution to journalArticle

Abstract

Organ transplantation is an increasingly used medical procedure for treating otherwise fatal end-stage organ diseases, and a large number of anti-rejection drugs have been developed to prolong long-term survival of both the individual and the transplanted organ. However, the prolonged use of immunosuppressive drugs is well known to increase the risk of opportunistic diseases, particularly infections and virus-related malignancies. Although transplant recipients experience a nearly twofold elevated risk for all types of de novo cancers, persistent infections with oncogenic viruses are associated with up to hundredfold increased risks. Women of the reproductive age are growing in number among the recipients of solid-organ transplants, but specific data on cancer outcomes are lacking. This article updates evidences linking iatrogenic immunosuppression, persistent infections with oncogenic viruses, other risk factors and post-transplant malignancies. Epidemiological aspects, tumourigenesis related to oncogenic viruses, clinical implications, as well as primary and secondary prevention issues are discussed to offer clinicians and researchers alike an update of an increasingly important topic.

Original languageEnglish
Pages (from-to)1251-1265
Number of pages15
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume28
Issue number8
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • cancer risk
  • iatrogenic immunosuppression
  • Kaposi's sarcoma
  • non-Hodgkin lymphoma
  • oncogenic viruses
  • solid-organ transplantation

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Medicine(all)

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