Mycophenolate mofetil and risk of developing malignancy after orthotopic heart transplantation: analysis of the transplant registry of the International Society for Heart and Lung Transplantation.

摘要: Background Malignancy after organ transplantation has been described as the "price of immunotherapy." Evolving strategies aimed at effective immunosuppression could have differing effects on likelihood developing malignancy. We analyzed data from transplant registry International Society for Heart and Lung Transplantation (ISHLT) to ascertain which factors are associated with development malignancy orthotopic heart (OHT). Methods Multivariate modeling was performed determine predictive first post-transplant in patients taking standard immunosuppressive regimens, defined cyclosporine or tacrolimus azathioprine mycophenolate mofetil (MMF), who underwent OHT between January 1, 1995 December 31, 1997. Results Of 3,895 transplants cohort, 703 (18%) developed any time during follow-up period, 549 (14%) within 5 years post-transplant. The breakdown follows: skin: 47%; lymphoproliferative disease: 10%; other malignancies: 24%; combination types: unreported: 10%. revealed that independent predictors increased risk were prior age, whereas use MMF part a regimen an adjusted relative (RR) = 0.73 (95% confidence interval 0.56 0.95). Relative recipient age 55 years, 30, 45 60 0.32, 0.46 1.37, respectively. Although appeared protective univariate analysis, it not significant according multivariate analysis. Female gender be protective. Neither OKT3 nor anti-thymocyte globulin (ATG) significantly Conclusions choice may affect OHT. Induction does appear increase subsequent regimens is lower