BACKGROUND: This retrospective single-center study was undertaken to assess the occurrence of de novo neoplasms in renal transplant recipients according to the immunosuppressive regimen and time after transplantation. MATERIAL/ METHODS: Observation encompassed 1028 patients transplanted between the years 1983-2006 and followed for 0.5-23 years. Patients with skin cancer other than melanoma were excluded due to incomplete data collection. RESULTS: Malignancy appeared in 4.8% (49) of the patients after the period of 5.8 ± 4.7 years at the age of 54 ± 13 years. The most common malignancies were urinary tract tumors (22%) and non-Hodgkin lymphoma with post-transplant lymphoproliferative disease (PTLD) (16%). Malignancy occurred in 5.2% of patients on cyclosporine (CSA), azathioprine (AZA) and prednisone (P); in 3.4% of patients on mofetil mycophenolate (MMF) with CSA and P; in 3.3% of patients on MMF with tacrolimus (TAC) and P; and in 2 of 20 patients (10%) receiving AZA with P 15 years after transplantation. The regimen consisting of CSA, AZA with P could be distinguished by the higher risk of malignancy occurrence. The occurrence of malignancy was significantly earlier on MMF+TAC+P compared to other regimens (p<0.05). The highest incidence of malignancy on AZA with P could be attributed to the longer observation period. CONCLUSIONS: In the new era of immunosuppression, despite lower occurrence, malignancy tends to appear earlier after the transplantation.
BACKGROUND: This retrospective single-center study was undertaken to assess the occurrence of de novo neoplasms in renal transplant recipients according to the immunosuppressive regimen and time after transplantation. MATERIAL/ METHODS: Observation encompassed 1028 patients transplanted between the years 1983-2006 and followed for 0.5-23 years. Patients with skin cancer other than melanoma were excluded due to incomplete data collection. RESULTS:Malignancy appeared in 4.8% (49) of the patients after the period of 5.8 ± 4.7 years at the age of 54 ± 13 years. The most common malignancies were urinary tract tumors (22%) and non-Hodgkin lymphoma with post-transplant lymphoproliferative disease (PTLD) (16%). Malignancy occurred in 5.2% of patients on cyclosporine (CSA), azathioprine (AZA) and prednisone (P); in 3.4% of patients on mofetil mycophenolate (MMF) with CSA and P; in 3.3% of patients on MMF with tacrolimus (TAC) and P; and in 2 of 20 patients (10%) receiving AZA withP 15 years after transplantation. The regimen consisting of CSA, AZA withP could be distinguished by the higher risk of malignancy occurrence. The occurrence of malignancy was significantly earlier on MMF+TAC+P compared to other regimens (p<0.05). The highest incidence of malignancy on AZA withP could be attributed to the longer observation period. CONCLUSIONS: In the new era of immunosuppression, despite lower occurrence, malignancy tends to appear earlier after the transplantation.