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Appears to increase risk after liver transplant in younger patients, those with C2 monitoring

-- Monica Smith

Wednesday, June 30, 2010 (Last Updated: 07/01/2010)

WEDNESDAY, June 30 (HealthDay News) -- Immunosuppressive treatment with cyclosporine A (CsA), rather than tacrolimus (TAC), with dose level monitoring two hours post-dosing (C2 monitoring) or in patients age 50 or younger appears to have a significant association with the development of de novo cancer after liver transplantation, according to research published in the July issue of Liver Transplantation.

Angela S.W. Tjon, M.D., of the Erasmus MC University Medical Centre in Rotterdam, Netherlands, and colleagues retrospectively analyzed 385 individuals who underwent liver transplantation between 1986 and 2007 to determine risk factors for de novo cancer in this population.

The researchers found that 50 (13 percent) of the patients developed at least one de novo cancer during the long-term follow-up. The cumulative incidence at one, five, 10, and 15 years was 2.9, 10.5, 19.4, and 33.6 percent, respectively. Liver transplantation patients had a 2.2 standardized incidence ratio of malignancy compared with the general population. In addition, the researchers found that the most important risk factor for development of de novo cancer in liver transplantation patients was immunosuppressive treatment with CsA instead of TAC, particularly in patients age 50 and younger and in more recent transplant patients (2005 to 2007 -- after the introduction of C2 monitoring).

"The ongoing international randomized trial comparing TAC with CsA-C2 in hepatitis C-related liver transplant patients might provide support to our finding. This study highlights the importance of re-evaluation and optimization of currently used immunosuppressive regimens," the authors conclude.

Tjon was financially supported by Biotest Pharma.

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Specialties Hematology & Oncology
OBGYN & Women's Health
Internal Medicine
Family Practice

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