Centre de référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant et Université de Lyon, Lyon, France.
Nephrol Dial Transplant. 2010 Feb;25(2):611-6. doi: 10.1093/ndt/gfp497. Epub 2009 Oct 10.
Cancer is a well-recognized complication of organ transplantation. The pattern of malignancies that occur in the paediatric graft population is different from that in the general paediatric population and in the population of adult organ transplant recipients.
We reviewed medical records from 240 consecutive paediatric renal transplantations performed in 219 children, aged less than 19 years, in our centre between April 1987 and March 2007. Data from patients who had been transferred into adult units were extracted from the French registries of dialysis and transplantation.
Among the 219 children who underwent renal transplantation during the study period, 16 (7.3%) developed malignancy. The cumulative incidence of cancer was 1.9, 4.0, 6.9 and 10.2% at 1, 5, 10 and 15 years post-transplantation, respectively. The 10-year incidence of post-transplantation lymphoproliferative disorder (PTLD) was 4.5%. Other identified cancers were Hodgkin lymphoma, Burkitt lymphomas, renal papillary carcinoma, thyroid papillary carcinoma, recurrent ovarian seminoma and skin cancer. The mortality rate was 25% (4/16).
Early detection of cancer in transplant recipients is of great importance. Regular screening for persistent Epstein-Barr virus (EBV) DNA viral load in patients at risk for developing PTLD is recommended. The occurrence of skin cancer in transplanted children is extremely rare during childhood, but cases can develop in early adulthood.
癌症是器官移植的一种公认的并发症。发生在儿科移植受者群体中的恶性肿瘤模式与普通儿科人群和成人器官移植受者群体中的模式不同。
我们回顾了 1987 年 4 月至 2007 年 3 月期间在我们中心进行的 219 例年龄小于 19 岁的 240 例连续儿科肾移植患者的医疗记录。从已转入成人单位的患者中提取了来自法国透析和移植登记处的数据。
在研究期间接受肾移植的 219 名儿童中，有 16 名（7.3%）发生了恶性肿瘤。癌症的累积发病率分别为 1 年、5 年、10 年和 15 年时的 1.9%、4.0%、6.9%和 10.2%。移植后淋巴增生性疾病（PTLD）的 10 年发生率为 4.5%。其他已确定的癌症包括霍奇金淋巴瘤、伯基特淋巴瘤、肾乳头状癌、甲状腺乳头状癌、复发性卵巢精原细胞瘤和皮肤癌。死亡率为 25%（4/16）。
早期发现移植受者中的癌症非常重要。建议对有发生 PTLD 风险的患者进行常规筛查，以监测持续的 EBV DNA 病毒载量。在儿童期，移植儿童患皮肤癌的情况极为罕见，但在成年早期可能会发生。
