Ovarian cancer after kidney transplantation

Malignancies are one of the major causes of morbidity and mortality in transplant patients. The incidence is progressively increasing either because of the increased age transplant patients and the increase of immunosuppressive therapy or the increased follow-up range post-transplantation. The main causes of increased tumor incidence in transplant patients with respect to the general population are the reduced immunosurveillance and the high incidence of infections due to oncogenic viruses. This problem might become more and more serious in the near future due to the introduction of new inummosuppressive strategies that significantly extend allograft survival. A case of ovarian cancer in a kidney transplant patient is described. Attention is focused on the potential dual role of immunosuppressive therapy in the development of malignancies in transplant patients.

Ovarian cancer; Kidney transplantation; Immunosuppressive drugs

[1] Bower M.: “The management of lymphoma in the immunosuppressed patient”. Best Pract. Res. Clin. Haematol., 2002, 15, 517.

[2] Winter P., Schoeneich G., Miersch W.D., Klehr H.U.: “Tumor induction as a consequence of immunosuppression after renal transplantation”. Int. Urol. Nephrol., 1997, 29, 701.

[3] Baccarani U., Adani G.L., Montanaro D., Risaliti A., Lorenzin D., Avellini C. et al.: “De novo malignancies after kidney and liver transplantations: experience on 582 consecutive cases”. Tranplant. Proc., 2006, 38, 1135.

[4] Penn I.: “Depressed immunity and development of cancer”. Cancer Detect. Prev., 1994, 18, 241.

[5] Penn I.: “Second malignant neoplasm associated with immunosoppressive medication”. Cancer, 1976, 37, 1024.

[6] Penn I.: “Malignancies associated with renal transplantation”. Urology, 1997, 10, 57.

[7] Ramsay H.M., Fryer A.A., Reece S., Smith A.G., Harden P.N.: “Clinical risk factors associated with nonmelanoma skin cancer in renal transplant recipients”. Am. J. Kidney Dis., 2000, 36, 167.

[8] Penn I.: “Post transplan malignancies”. Transplant Pro., 1999, 31, 1260.

[9] United Network For Organ Sharing, www.unos.org, 2003.

[10] Penn I.: “Immunosuppression – a contributory factor in lymphoma formation”. Clin. Transplant, 1992, 6, 214.

[11] Stallone G., Infante B., Schena A., Grandaliano G., Di Paolo S., Scolari M.P. et al.: “Malignant neoplasia and renal transplant”. Italian J. Nefrol., 2003, 20, 611.

[12] Kasiske B.L., Snyder J.J., Gilbertson D.T., Wang C.: “Cancer after kidney transplantation in the United States”. Am. J. Transplant, 2004, 4, 905.

[13] Boshoff C.: “Kaposi’s sarcoma biology”. IUBMB Life, 2002, 53, 259.

[14] Meier-Kriesche H., Ojo A., Hanson J., Kaplan B.: “Exponentially increased risk of infectious death in older renal transplant recipients”. Kidney Int., 2001, 59, 1539.

[15] Penn I.: “Malignancy after immunosuppressive therapy : how can the risk be reduce?”. Clin. Immunotherapy, 1995, 4, 207.

[16] Infante B., Stallone G., Schena A. et al.: “Pro and anti-neoplastic effects of immunosuppressive drug in renal transplantation”. Ital. J. Nefrol., 2006, 23, 389.

[17] Kahan B.D.: “Cyclosporine”. N. Engl. J. Med., 1989, 321, 1725.

[18] Masuhara M., Ogasawara H., Katyal S.L., Nakamura T., Shinozuka H.: “Cyclosporine stimulates hepatocyte proliferation and accelerates development of hepatocellular carcinomas in rats”. Carcinogenesis, 1993, 14, 1579.

[19] Hojo M., Morimoto T., Maluccio M., Asano T., Morimoto K., Milagros Lagman M. et al.: “Cyclosporine induces cancer progression by a cell-autonomous mechanism”. Nature, 1999, 397, 530.

[20] Herman M., Weinstein T., Korzets A., Chagnac A., Ori Y., Zevin D. et al.: “Effect of cyclosporin A on DNA repair and cancer incidence in kidney transplant recipients”. J. Lab. Clin. Med., 2001, 137, 14.

[21] Twentyman P.R., Fox N.E., White D.J.: “Cyclosporin A and its analogues as modifiers of adriamycin and vincristine resistance in a multi-drug resistent human lung cancer cell line”. Br. J. Cancer, 1987, 56, 55.

[22] Veroux M., Pulitati C., Fiamingo P.: “Early de novo malignances after kidney transplantation”. Transplant Proc., 2004, 36, 718

[23] Startzl T.E., Nalesnik M.A., Porter K.A.: “Reversibility of lynphomas and lynphoproliferatuive lesion developig under cyclosporin-steroid therapy”. Lancet, 1984, 1, 583.