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药物免疫抑制期间的新发恶性肿瘤。1080例患者1245例尸体肾移植后的结果

[De novo malignant tumors during drug immunosuppression. The findings following 1245 cadaveric kidney transplants in 1080 patients].

作者信息

Walz M K, Albrecht K H, Niebel W, Eigler F W

机构信息

Abteilung für Allgemeine Chirurgie, Universitätsklinikum Essen.

出版信息

Dtsch Med Wochenschr. 1992 Jun 12;117(24):927-34. doi: 10.1055/s-2008-1062393.

Abstract

Thirty new malignant tumours were found in 1080 patients (634 men, 446 women; mean age 37.6 +/- 13.6 years) after a median follow-up period of 5 years following 1245 cadaveric kidney transplantations performed between 1972 and 1990. The mean dialysis period before transplantation had been 4.0 +/- 3.1 years. Regarding the type of tumour, carcinomas were by far the most frequent, while there was only one lymphoma. The annual malignancy incidence for renal transplant patients was 0.5%. This is 3.5 times higher for men and 4.2 times for women than in the normal population. Immunosuppression with azathioprine and/or antithymocytic globulin (n = 395) produced the same malignancy incidence (0.54%) as with cyclosporin (n = 685; 0.60%). On the other hand, malignant tumours occurred much earlier under cyclosporin than under azathioprine/antithymocytic globulin (27 and 68 months, respectively).

摘要

在1972年至1990年间进行的1245例尸体肾移植术后,经过5年的中位随访期,在1080例患者(634例男性,446例女性;平均年龄37.6±13.6岁)中发现了30例新的恶性肿瘤。移植前的平均透析期为4.0±3.1年。就肿瘤类型而言,癌是最常见的,仅有1例淋巴瘤。肾移植患者的年恶性肿瘤发病率为0.5%。这一发病率在男性中比正常人群高3.5倍,在女性中比正常人群高4.2倍。使用硫唑嘌呤和/或抗胸腺细胞球蛋白进行免疫抑制(n = 395)与使用环孢素(n = 685;0.60%)产生的恶性肿瘤发病率相同(0.54%)。另一方面,恶性肿瘤在使用环孢素治疗时比使用硫唑嘌呤/抗胸腺细胞球蛋白时出现得更早(分别为27个月和68个月)。

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