Ippoliti Giovanbattista, Rinaldi Mauro, Pellegrini Carlo, Viganò Mario
Divisione di Medicina Interna, Ospedale Civile, V. Volturno 14, 27048 Voghera, Pavia, Italy.
Crit Rev Oncol Hematol. 2005 Oct;56(1):101-13. doi: 10.1016/j.critrevonc.2005.03.013.
Prolonged or intensive immunosuppressive therapy used after organ transplantation is complicated by an increased incidence of cancer. Striking differences in incidence are observed in heart and heart-lung transplant recipients when compared with renal transplant patients. The most significant increase was in the incidence of lymphomas in cardiac versus renal patients. Moreover, a two-fold greater increase of all neoplasms was found in cardiac recipients, with nearly a six-fold increase in visceral tumors. Several factors may account for these differences. In cardiac allograft recipients, intensive immunosuppression is frequently used to reverse acute rejection and the highest number of cardiac transplants was performed in the era of polypharmacy, usually consisting of triple therapy.
器官移植后使用的延长或强化免疫抑制疗法会因癌症发病率增加而变得复杂。与肾移植患者相比，心脏和心肺移植受者的发病率存在显著差异。心脏移植患者与肾移植患者相比，淋巴瘤发病率的增加最为显著。此外，心脏移植受者所有肿瘤的发病率增加了两倍，内脏肿瘤的发病率几乎增加了六倍。有几个因素可以解释这些差异。在心脏同种异体移植受者中，经常使用强化免疫抑制来逆转急性排斥反应，并且在联合用药时代进行的心脏移植数量最多，联合用药通常包括三联疗法。
