Malignancies in transplant patients under cyclosporine treatment for more than 10 years

Abstract

Long-term immunosuppressive therapy after renal transplantation with different kinds of drugs carries an increased risk of development of malignant disease [1–4]. Except for preexisting or undetected cases most of the malignancies in graft recipients are de-novo malignancies developing at various times after transplantation. Due to the growing number of patients exposed to the risk a careful follow-up observation with documentation of developing malignancies is mandatory. This is in particular important for newer drugs such as cyclosporine A (CsA). The number of reports concerning the risk of developing de-novo malignancies under use of CsA has increased during the last years [5–8]. However in most of them only short observation times were covered. To evaluate if there is a excess risk in the long-term a suitable number of patients observed for 10 ore more years is necessary. In other reports the numbers of patients without malignancy were not reported. Furthermore they consisted of heterogeneous populations with different therapeutic regimens and different ethnic and geographic background. A comparison to a nontransplantated control population was often not made. The purpose of the present study was to give an update of our previous reports [5, 9] and to analyze the risk for development of malignant disease in a homogenous population in respect to immunosuppressive treatment and ethnic and geographic background. A regional cancer registry was used for comparison.