CHIP, Department of Infectious Diseases, Centre for Cardiac, Pulmonary and Infectious Diseases Vascular, University of Copenhagen, Rigshospitalet, Section 2100, Blegdamsvej 9, 2100 Copenhagen, Copenhagen Ø, Denmark.
Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), University College London, London, UK.
J Cancer Res Clin Oncol. 2019 Dec;145(12):3125-3135. doi: 10.1007/s00432-019-03039-2. Epub 2019 Nov 5.
Solid organ (SOT) and allogeneic haematopoietic stem cell (HSCT) transplant recipients have elevated risks of de novo or secondary cancer. We explored risk factors hereof.
Among SOT and HSCT between January 2004 and December 2014, standardised incidence ratio (SIR) of de novo/secondary cancer compared with the Danish population was determined and risk factors were identified using Poisson regression.
During a median of 3.4 (IQR 1.3-6.4) and 2.6 (0.8-5.4) person-years (PY) after SOT and HSCT, a total of 212/1656 (13%) and 75/992 (8%) persons developed cancer; SIR 3.61 (3.0-4.3) and 2.2 (1.6-3.0), resp.). SIR correlated with younger age and was highest for skin and haematological cancers for both types of transplantation. Within the cohort, cancer was associated with older age (adjusted incidence rate ratio > 50 vs ≤ 19 years, among SOT and HSCT: 9.4 (3.4-25.7) and 25.4 (5.1-126.0), resp.) and current elevated C-reactive protein (CRP) (≥ 10 vs < 10 mg/L: 2.5 (1.8-3.4) and 2.3 (1.4-3.9), resp.), but neither with prior cancer nor type of immunosuppressants.
Rates of de novo or secondary cancers are elevated in both SOT and HSCT compared with the general population and mainly for skin and haematological cancers. Among transplant recipients, older age and current elevated CRP are risk factors.
实体器官（SOT）和异基因造血干细胞（HSCT）移植受者新发或继发性癌症的风险增加。我们在此探讨其风险因素。
在 2004 年 1 月至 2014 年 12 月期间进行的 SOT 和 HSCT 中，与丹麦人群相比，新发/继发性癌症的标准化发病比（SIR）确定，并使用泊松回归确定风险因素。
在 SOT 和 HSCT 后的中位 3.4（IQR 1.3-6.4）和 2.6（0.8-5.4）人年（PY）期间，共有 212/1656（13%）和 75/992（8%）患者发生癌症；SIR 分别为 3.61（3.0-4.3）和 2.2（1.6-3.0）。SIR 与年龄较小相关，且在两种类型的移植中，皮肤和血液系统癌症的 SIR 最高。在该队列中，癌症与年龄较大相关（调整后的发病率比，50 岁以上与≤19 岁相比，SOT 和 HSCT 分别为 9.4（3.4-25.7）和 25.4（5.1-126.0）），并且与当前升高的 C 反应蛋白（CRP）相关（≥10 与<10mg/L 相比，分别为 2.5（1.8-3.4）和 2.3（1.4-3.9）），但与既往癌症或免疫抑制剂类型无关。
与普通人群相比，SOT 和 HSCT 中新发或继发性癌症的发生率均升高，主要为皮肤和血液系统癌症。在移植受者中，年龄较大和当前升高的 CRP 是危险因素。
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