Incidence and Risk Factors for Nonmelanoma Skin Cancer After Heart Transplantation
Por:
Molina, BD, Leiro, MGC, Pulpon, LA, Mirabet, S, Yanez, JF, Bonet, LA, Vilchez, FG, Delgado, JF, Manito, N, Rabago, G, Arizon, JM, Romero, N, Roig, E, Blasco, T, Pascual, D, de la Fuente, L, Muniz, J
Publicada:
1 oct 2010
Resumen:
Introduction. The incidence of skin cancer in heart transplant (HT) patients is higher than in the general population, reversing the proportion of cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with a predominance of the former. The etiologic role of new immunosuppressants is not well known. We sought to ascertain the incidence of SCC and BCC in HT patients and the risk factors for its occurrence.
Patients and Methods. We report the incidence of all types of post-HT skin cancer, SCC, and BCC among adult HT patients in Spain (4089 subjects) as well as the influence of gender, age at heart transplant, immunosuppression, and sunlight exposure.
Results. The incidence rates of SCC and BCC, per 1000 persons/year, were 8.5 and 5.2, respectively. Males had a higher risk of SCC but not BCC. Induction therapy increased the risk of SCC and BCC. The relative risk of mycophenolate mofetil (MMF) was 0.3 (0.2-0.6; P < .0005) and azathioprine (AZA) 1.8 (1.2-2.7; P < .0032) for SCC, whereas tacrolimus and cyclosporine showed no difference. The relative risk of BCC was not affected by any immunosuppressant.
Conclusion. Age at transplantation >45 years, induction therapy use, and high sunshine zone were risk factors for both SCC and BCC. Different immunosuppressive agents have different risks of nonmelanoma skin cancer, as AZA increases the risk of SCC and MMF is a protective factor. The relative risk of BCC was not affected by any immunosuppressor.
Filiaciones:
Molina, BD:
Hosp Univ Cent Asturias, Area Corazon, Heart Transplant Unit, Oviedo 33012, Spain
Leiro, MGC:
Hosp Univ A Coruna, Heart Transplant Unit, La Coruna, Spain
Pulpon, LA:
Hosp Puerta Hierro, Heart Transplant Unit, Madrid, Spain
Mirabet, S:
Hosp Sta Creu i San Pau, Heart Transplant Unit, Barcelona, Spain
Yanez, JF:
Hosp Gregorio Maranon, Heart Transplant Unit, Madrid, Spain
Bonet, LA:
Hosp La Fe, Heart Transplant Unit, Valencia, Spain
Vilchez, FG:
Hosp Valdecilla, Heart Transplant Unit, Santander, Spain
Delgado, JF:
Hosp Doce Octubre, Heart Transplant Unit, Madrid, Spain
Manito, N:
Hosp Bellvitche, Heart Transplant Unit, Barcelona, Spain
Rabago, G:
Univ Navarra Clin, Heart Transplant Unit, Pamplona, Spain
Arizon, JM:
Hosp Reina Sofia, Heart Transplant Unit, Cordoba, Spain
Romero, N:
Hosp Virgen del Rocio, Heart Transplant Unit, Seville, Spain
Roig, E:
Hosp Clin Barcelona, Heart Transplant Unit, Barcelona, Spain
Blasco, T:
Hosp Miguel Servet, Heart Transplant Unit, Zaragoza, Spain
Pascual, D:
Hosp Virgen Arrixaca, Heart Transplant Unit, Murcia, Spain
de la Fuente, L:
Clin Univ Valladolid, Heart Transplant Unit, Valladolid, Spain
Muniz, J:
Univ A Coruna, Inst Univ Ciencias Salud, La Coruna, Spain
Open Access
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