Literature DB >> 22377788

Anogenital malignancies in women after renal transplantation over 40 years in a single center.

Kim A P Meeuwis1, Willem J G Melchers, Hanneke Bouten, Peter C M van de Kerkhof, Floor Hinten, Wim G V Quint, Leon F A G Massuger, Andries J Hoitsma, Michelle M van Rossum, Joanne A de Hullu.   

Abstract

BACKGROUND: Renal transplant recipients have an increased risk to develop human papillomavirus (HPV)-related anogenital malignancies. A clinical overview of female anogenital posttransplantation malignancies and possible multifocal premalignancies over a period of 40 years renal transplantation is presented. Additionally, the genotype-specific prevalence of HPV in these (pre)malignancies was investigated.
METHODS: Data of 1023 women, who underwent a renal transplantation between 1968 and 2008, were collected. Clinical data of all female renal transplant recipients who developed anogenital malignancies were retrospectively analyzed. The histology, cytology, and distribution of genotype-specific HPV infections were analyzed in all primary anogenital tumors and possible (multifocal) premalignancies.
RESULTS: Sixteen anogenital malignancies (1.6%) were found: vulva (n=6), cervix (n=5), and anus (n=5). Twelve of 16 patients never had a cervical smear before transplantation. The median interval between transplantation and diagnosis of malignancy was 136 months (range, 16-288 months). High-risk HPV was detected in 91.7% of investigated lesions, HPV subtype 16 predominated (54.5%). Four of seven patients with two distinct anogenital lesions had different HPV types in the lesions.
CONCLUSIONS: A high number of anogenital malignancies developed in our cohort, which are nearly all caused by HPV. Multifocal lesions within one patient frequently contained different high-risk HPV genotypes in both lesions. Our results underline the importance of anogenital screening and monitoring before and periodically after renal transplantation to prevent morbidity and mortality from anogenital malignancies.

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Year:  2012        PMID: 22377788     DOI: 10.1097/TP.0b013e318249b13d

Source DB:  PubMed          Journal:  Transplantation        ISSN: 0041-1337            Impact factor:   4.939


  12 in total

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