Fogel Alexander L, Miyar Maria, Teng Joyce M C
School of Medicine, Stanford University, Stanford, California.
Department of Dermatology, Kaiser Permanente, San Jose, California.
Pediatr Dermatol. 2016 Nov;33(6):585-593. doi: 10.1111/pde.12941. Epub 2016 Jul 28.
Pediatric organ transplant recipients (POTRs) are at risk of developing malignancies due to a combination of immunosuppression, impaired DNA damage repair, and infection with oncogenic viruses. The most commonly developed malignancies in this population are skin cancers, which include nonmelanoma skin cancer, melanoma, Kaposi's sarcoma, and anogenital carcinoma. The literature shows that skin cancers account for 13% to 55% of all cancers that occur after transplantation. Given the increasing number and life expectancy of POTRs, prevention and management of skin cancer in these patients is essential, but there is a substantial knowledge gap in our understanding of the differences in skin cancer development, prevention, and management between POTRs and adult organ transplant recipients (AOTRs), for whom more data are available. Substantial differences have been observed in the patterns of malignancy development between POTRs and AOTRs, and data specific to pediatric populations are needed. The objective of this review is to provide updated information on posttransplantation skin cancer development in POTRs, including epidemiologic research on transplant patients and disease development, medication management, surveillance, and education efforts.
儿科器官移植受者（POTRs）由于免疫抑制、DNA损伤修复受损以及致癌病毒感染等多种因素，面临发生恶性肿瘤的风险。该人群中最常发生的恶性肿瘤是皮肤癌，包括非黑色素瘤皮肤癌、黑色素瘤、卡波西肉瘤和肛门生殖器癌。文献表明，皮肤癌占移植后发生的所有癌症的13%至55%。鉴于POTRs的数量不断增加以及预期寿命延长，对这些患者进行皮肤癌的预防和管理至关重要，但在我们对POTRs与成人器官移植受者（AOTRs）在皮肤癌发生、预防和管理方面的差异的理解上存在很大的知识空白，针对AOTRs有更多可用数据。在POTRs和AOTRs之间观察到恶性肿瘤发生模式存在显著差异，需要针对儿科人群的具体数据。本综述的目的是提供关于POTRs移植后皮肤癌发生的最新信息，包括对移植患者的流行病学研究以及疾病发生、药物管理、监测和教育工作。
