PMID- 26107280
OWN - NLM
STAT- MEDLINE
DCOM- 20151106
LR  - 20150625
IS  - 1526-9248 (Print)
IS  - 1526-9248 (Linking)
VI  - 25
IP  - 2
DP  - 2015 Jun
TI  - Immunosuppressant-driven de novo malignant neoplasms after solid-organ 
      transplant.
PG  - 182-8
LID - 10.7182/pit2015826 [doi]
AB  - Solid-organ transplant recipients are at a 3- to 5-fold increased risk of a de 
      novo malignant neoplasm developing compared with the general population. The most 
      frequently developed virus-associated malignant neoplasms are Kaposi sarcoma 
      (standardized incidence ratio [SIR], 208.0), nonmelanoma skin cancer (SIR, 28.6), 
      and posttransplant lymphoproliferative disorder, primarily non-Hodgkin lymphoma 
      (SIR, 8.1). Immunosuppressive agents such as corticosteroids, antimetabolites, 
      calcineurin inhibitors, and mammalian target of rapamycin (mTOR) inhibitors play 
      a key role in either causing or preventing this complication. It is hypothesized 
      that some of these regimens can impair cancer surveillance, facilitate the action 
      of oncogenic viruses, and promote direct oncogenic activity. Evolving research 
      has shown promising dual antitumor and immunosuppressive properties of the mTOR 
      inhibitor class. The effective management of posttransplant neoplasms most likely 
      involves the use of these medications among other preventative options. These 
      measures include monitoring certain viral loads as well as immunosuppressant drug 
      levels. Reducing these levels to as low as possible for healthy engraftment and 
      altering regimens when appropriate are management strategies that could lessen 
      this complication of solid-organ transplant. More studies examining the effects 
      of therapeutic drug monitoring are needed to determine specific plasma drug 
      concentrations that will ensure organ engraftment without the development of de 
      novo malignant neoplasms.
FAU - Billups, Kelsey
AU  - Billups K
AD  - Virginia Commonwealth University, Richmond, Virginia.
FAU - Neal, Jennifer
AU  - Neal J
AD  - Virginia Commonwealth University, Richmond, Virginia.
FAU - Salyer, Jeanne
AU  - Salyer J
AD  - Virginia Commonwealth University, Richmond, Virginia.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Prog Transplant
JT  - Progress in transplantation (Aliso Viejo, Calif.)
JID - 100909380
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunosuppressive Agents)
MH  - Antineoplastic Agents/*therapeutic use
MH  - Graft Rejection/*drug therapy/*prevention & control
MH  - Humans
MH  - Immunosuppressive Agents/*adverse effects
MH  - Kidney Transplantation/*adverse effects
MH  - Neoplasms/*drug therapy/*etiology
MH  - Risk Factors
MH  - Transplants/drug effects
EDAT- 2015/06/25 06:00
MHDA- 2015/11/07 06:00
CRDT- 2015/06/25 06:00
PHST- 2015/06/25 06:00 [entrez]
PHST- 2015/06/25 06:00 [pubmed]
PHST- 2015/11/07 06:00 [medline]
AID - 10.7182/pit2015826 [doi]
PST - ppublish
SO  - Prog Transplant. 2015 Jun;25(2):182-8. doi: 10.7182/pit2015826.