In this study, researchers evaluated the risk of de novo cancer after intestinal transplantation.
They assessed a total of 168 consecutive intestinal transplant recipients.
They also used Surveillance, Epidemiology, and End Results data to calculate the expected rates of de novo cancers in the general population.
Mean follow-up was 47 months; during this time 4% of patients developed non-lymphoid de novo cancer. Cumulative risk was 3% at 5 years and 28% at 10 years.
|Morbidity was higher in patients under 25.|
The team calculated that the expected rate of malignancy in the general population was 0.58. They found that the risk among intestinal recipients was 8.7 times higher.
In addition, morbidity was significantly higher in patients under 25.
The researchers determined that induction immunosuppression was associated with early onset of de novo cancer.
Patient survival after diagnosis of de novo cancer was 72% at 1 year, 57% at 2 years, and 29% at 5 years.
Dr Kareem Abu-Elmagd and colleagues concluded, "With conventional immunosuppression, intestinal recipients are at a significantly higher risk of developing de novo cancer when compared with the general population".
"Thus, a novel tolerogenic immunosuppressive strategy has been recently implemented to reduce the lifelong need for immunosuppression."