The risk of neoplasms in patients treated with cyclosporine A.

Immunosuppressive therapy (IT) carries inherent risks involving the occurrence of lymphoproliferative disorders and malignancies (MA). The most frequently observed neoplasms in organ-transplant (OT) recipients treated with cyclosporine A (Cy-A) involve the skin and the lympho-reticular system. A disproportionally high percentage of the skin MA are Kaposi's sarcoma. Compared with a normal, not-exposed population matched for age, sex and country; Cy-A-treated OT recipients have a 28-times higher prevalence of lymphomas. This figure compares with a 34 to 59-fold increased risk in patients receiving conventional immunosuppressive therapy (CIT) for OT. However, it appears that in Cy-A-treated patients the latency period for the development of lymphomas is shorter than in patients on CIT. Other MA are increased seven-fold in Cy-A-treated patients and between two- and six-fold in those receiving CIT. The overall incidence of all types of MA is increased two-fold for Cy-A recipients and between two- and four-fold for those on CIT. Therefore patients receiving IT should be carefully monitored with respect to the possible occurrence of neoplasms.