Literature DB >> 19890737

Regression of advanced melanoma upon withdrawal of immunosuppression: case series and literature review.

P Dillon1, N Thomas, N Sharpless, F Collichio.   

Abstract

We report two cases of stage IV malignant melanoma arising in patients treated with azathioprine for myasthenia gravis. In both cases, the melanoma metastases regressed upon withdrawal of immunosuppression. One patient remains melanoma free at 10 years, and the second patient experienced an 18-month disease free period. There is one prior case report in the medical literature to support full immune reconstitution for treatment in advanced immunosuppression-related melanoma, and one case series suggesting that transplant patients developing melanoma may benefit from a switch to sirolimus. Virtually, no data exist for the medical management of early stage melanoma in the immunosuppressed patients. We review the limited preclinical data in support of immune reconstitution and the data on immunosuppression as a risk factor for melanoma. We conclude that reduction or withdrawal of immunosuppression may be beneficial in patients with advanced stage melanoma and warrants further consideration in patients with early stage melanoma.

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Year:  2009        PMID: 19890737      PMCID: PMC3725585          DOI: 10.1007/s12032-009-9348-z

Source DB:  PubMed          Journal:  Med Oncol        ISSN: 1357-0560            Impact factor:   3.064


  64 in total

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Journal:  JAMA       Date:  2001-04-04       Impact factor: 56.272

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3.  Primary cutaneous melanoma: a complication of infliximab treatment?

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Review 4.  Cancer immunoediting: from immunosurveillance to tumor escape.

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5.  Incidence of skin cancer in 5356 patients following organ transplantation.

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Journal:  Br J Dermatol       Date:  2000-09       Impact factor: 9.302

Review 6.  High-dose recombinant interleukin 2 therapy for patients with metastatic melanoma: analysis of 270 patients treated between 1985 and 1993.

Authors:  M B Atkins; M T Lotze; J P Dutcher; R I Fisher; G Weiss; K Margolin; J Abrams; M Sznol; D Parkinson; M Hawkins; C Paradise; L Kunkel; S A Rosenberg
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7.  Cancer regression and autoimmunity in patients after clonal repopulation with antitumor lymphocytes.

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Review 8.  Skin cancer in organ transplant recipients: Epidemiology, pathogenesis, and management.

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Review 9.  Focus on TILs: prognostic significance of tumor infiltrating lymphocytes in human melanoma.

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10.  Nodular malignant melanoma and multiple cutaneous neoplasms under immunosuppression with azathioprine.

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