Malignant Neoplasia in the Immunocompromised Patient


The burgeoning numbers of patients who undergo cardiac or pulmonary transplantation make it increasingly important that cardiologists, pulmonologists and cardiothoracic surgeons be familiar with the complications of these treatments. One of these is an increased risk for the development of certain types of cancer. Much of this chapter is based on experience obtained from renal transplantation, but whenever possible observations made in cardiac, cardiopulmonary or pulmonary graft recipients (henceforth referred to as cardiothoracic [CT] recipients) will be stressed. The report is based on data collected by the Cincinnati Transplant Tumor Registry (CTTR) up till May 1995.


Transplant Recipient Skin Cancer Renal Transplant Recipient Uterine Cervix Organ Transplant Recipient 


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  1. 1.
    Penn I. Donor transmitted disease; cancer. Transplant. Proc. 1991;23:2629.PubMedGoogle Scholar
  2. 2.
    Penn I. Malignancy in transplanted organs (editorial). Transplant Int. 1993;6:1.CrossRefGoogle Scholar
  3. 3.
    Penn I. Precautions to be taken to prevent transmission of ncoplastic diseases in the grafting process. In: Englert Y. editor. Organ and tissue transplantation in the European Union: management of difficulties and health risks linked to donors. Dordrecht: Martinus Nijhoff: 1995:47.Google Scholar
  4. 4.
    Penn I. The effect of renal transplantation in patients with a history of curative cancer therapy. In: Stewart THM, Wheelock HF, editors. Cellular immune mechanisms and tumor dormancy. Boca Raton: CRC Press: 1992:239.Google Scholar
  5. 5.
    Penn I. Effects of immunosuppression on pre-existing cancers. Transplantation. 1993;55:742.PubMedCrossRefGoogle Scholar
  6. 6.
    Penn I. Why do immunosuppressed patients develop cancer? In: Pimemel E, editor. CRC critical reviews in ontogenesis. Boca Raton: CRC Press. 1989;1:27.Google Scholar
  7. 7.
    Penn I. Tumors after renal and cardiac transplantation. Hematol-Oncol Clin N Am. 1993;7:431.Google Scholar
  8. 8.
    Penn I. The problems of cancer in organ Transplant recipients: an overview. Transplant Sci. 1994;4:23PubMedGoogle Scholar
  9. 9.
    Weintraub J, Warlike RA. Lymphoma in cardiac allograft recipients. Clinical and histological features and immunological phenotype. Transplantation. 1982;33:347.PubMedCrossRefGoogle Scholar
  10. 10.
    Lanza RP, Cooper DKC, Cassidy MJC, Barnard CN. Malignancy following cardiac transplantation. J Am Med Assoc. 1993;249:1746.CrossRefGoogle Scholar
  11. 11.
    Bernstein D. Baum D, Berry G et al. Neoplastic disorders after pediatric heart transplantation. Circulation. 1993;88:230.Google Scholar
  12. 12.
    Sheil AGR, Disney APS, Mathew TH, Amiss N. De novo malignancy emerges as a major cause of morbidity and late failure in renal transplantation. Transplant Proc. 1993;25:1383.PubMedGoogle Scholar
  13. 13.
    Sheil AGR. Skin cancer in renal transplant recipients. Transplant Sci. 1994;4:42.PubMedGoogle Scholar
  14. 14.
    Btohme I. Brynger H. Malignant disease in renal transplant patients. Transplantation. 1985;39:23.Google Scholar
  15. 15.
    Kinlen LJ, Sheil AGR. Peto J, Doll R. Collaborative United Kingdom-Australasian study of cancer in patients treated with immunosuppressive drugs. Br Med J. 1979;2:1461.PubMedCrossRefGoogle Scholar
  16. 16.
    Kinlen LJ. Incidence of cancer in rheumatoid arthritis and other disorders after immunosuppressive treatment, Am J Med 1985;78:44.PubMedCrossRefGoogle Scholar
  17. 17.
    Harwood AR, Osaba D, Hofstader SL et al. Kaposi’s sarcoma in recipients of renal transplants. Am J Med. 1979;67:759.PubMedCrossRefGoogle Scholar
  18. 18.
    Porrecco R, Penn I, Droegemueller W, Greer B, Makowski E. Gynecologic malignancies in immunosuppressed organ homograft recipients. Obstet Gynecol. 1975;45:359.Google Scholar
  19. 19.
    Hartevelt MM, Bouwes-Bavinck JN, Koote AM, Vermeer BJ, Vandenbroucke JP. Incidence of skin cancer after renal transplantation in the Netherlands. Transplantation. 1990;49:506.PubMedCrossRefGoogle Scholar
  20. 20.
    Mullen DL, Silberberg SG, Penn I. Hammond WS. Squamous cell carcinoma of the skin and lip in renal homograft recipients. Cancer. 1976;37:729.PubMedCrossRefGoogle Scholar
  21. 21.
    Penn I, Porat G. Central nervous system lymphomas in organ allograft recipients. Transplantation. 1995;59:240.PubMedGoogle Scholar
  22. 22.
    Nalcsnik MA. Starzl. TH. Epstein-Barr virus, infectious mononucleosis, and post-transplant lymphoproliferative disorders. Transplant Sci. 1994;4:61.Google Scholar
  23. 23.
    Hanto DW. Classification of Epstein-Barr virus-associated posttransplant lyinpho-proliferative diseases: implications for understanding their palhogenesis and developing rational treatment strategies. Annu Rev Med. 1995;46:381.PubMedCrossRefGoogle Scholar
  24. 24.
    Penn I. Kaposi’s sarcoma-etiology: immunodeficiency In: Ziegler JL, Dorfman RF, editors. Kaposi’s sarcoma, pathophysiology and clinical management. New York: Marcel Dekker: 1988:129.Google Scholar
  25. 25.
    Penn I. Cancers of the anogenital region in renal transplant recipients: analysis of 65 cases. Cancer. 1986;58:61.CrossRefGoogle Scholar
  26. 26.
    Sillman F, Stanek A, Sedlis A et al. The relationship between human papillomavirus and lower genital intraepithelial neoplasia in immunosuppressed women. Am J Obstet Gynecol. 1984;150:300.PubMedGoogle Scholar
  27. 27.
    Penn I. Primary kidney tumors before and after renal transplantation. Transplantation. 1995;59:480.PubMedGoogle Scholar
  28. 28.
    Ishikawa I. Acquired cysts and neoplasms of the kidney in renal allograft recipients. In: Berlyne GM. editor. The kidney today: selected topics in renal science. Basel, Karger: Contrib. Nephrol. 1992;100:254.Google Scholar
  29. 29.
    Shroter GPJ, Weil R III. Penn I, Speers WC. Wuddell WR. Hepatocellular carcinoma associated with chronic hepatitis B virus infection alter kidney transplantation (Letter). Lancet. 1982;2:381.CrossRefGoogle Scholar
  30. 30.
    Barret WL, First R, Aron BS, Penn I. Clinical course of malignancies in renal transplant recipients. Cancer. 1993;72:2186CrossRefGoogle Scholar
  31. 31.
    Nalesnik MA, Locker J, Jaffe R et al. Experience with posttransplant lymphoprolife erative disorders in solid organ transplant recipients. Clin Transpl. 1492;6:249.Google Scholar
  32. 32.
    Brumbaugh J, Baldwin JC, Stinson EB et al. Quantitative analysis of immunosuppression in cyclosporine-treated heart transplant patients with lymphoma. J Heart Transplant. 1985;4:307.PubMedGoogle Scholar
  33. 33.
    Eurvard S, Verschoore M. Touraine JL et al. Topical retinoids for warts and keratoses in transplant recipients (Letter). Lancet. 1992;340:48.Google Scholar
  34. 34.
    Magnone M, Holley JL, Shapiro R et al. Inlerferon-alpha-indueed acute renal allograft rejection. Transplantation. 1995;59:1068.PubMedCrossRefGoogle Scholar

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© Kluwer Academic Publishers 1996

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  • I. Penn

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