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Kidney Week

Abstract: PO2471

Secondary Malignancy in Kidney Transplant Recipients: University of Southern California Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Wong, Alexandra K., Keck Hospital of USC, Los Angeles, California, United States
  • Truong, Tiffany, Keck Hospital of USC, Los Angeles, California, United States
  • Vaidya, Poorva, Keck Hospital of USC, Los Angeles, California, United States
  • In, Gino, Keck Hospital of USC, Los Angeles, California, United States
  • Maw, Thin Thin, Keck Hospital of USC, Los Angeles, California, United States
Background

Kidney transplant recipients (KTR) on immunosuppressive therapy are at higher risk of developing secondary malignancy (SM). Although previous studies have demonstrated this increased risk, much remains to be elucidated regarding the spectrum of SM and the contributing factors to morbidity and mortality.

Methods

We conducted a retrospective review of all KTR from April 2005 to December 2017 at our institution. We then selected only those patients with SM, and collected demographics, variables related to kidney transplant, malignancy, and outcomes.

Results

Among 1414 KTR, 84 patients (pts) had post-tx SM. Forty-five percent of pts were Hispanic, 33% Caucasian, 11% Asian and 6% African American. Twenty four pts (28%),11 pts (13%),and 51 pts (59%) developed cutaneous malignancy, hematological malignancy and solid organ malignancy (SOM) respectively. One patient developed both a secondary cutaneous and SOM, while another pt developed 2 different SOM.
46 (55%) pts were deceased by 1/1/20: 25 pts died from malignancy and 9 pts died from infection. Among those 46 pt, 37 pts ( 80%) had intact graft function at death. Eleven pts (13%) had malignancy prior to tx. The induction was rATG (36%) and basiliximab (41%). 20 pts had biopsy-proven acute rejection; of these 75% was prior to and 25% was post cancer diagnosis. 18 pts were switched to mTOR inhibitor from tacrolimus and cellcept was stopped in 22 pts.

Conclusion

We describe a wide range of SM among a diverse population of KTR, with nearly half of our patients being Hispanic. This highlights the need for further investigation of the impact of ethnicity on SM. Among our KTR, SM was the cause of death for 25 pts and infection was for 9 pts. Regardless of etiology, the majority of pts (80%) had intact graft function at death. Our findings illustrate the need for vigilant cancer screening and additional strategies to decrease cancer risk and death in KTR.

Type of cancerN = 86%
GU1619
Thoracic1416
GYN22
GI1416
Sarcoma34
Hematological1113
Skin2428
Primary unknown22