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Cancer Risks Similar With Different Immunosuppressants

After kidney transplantation, three immunosuppressant regimens carry similar risks

FRIDAY, April 30 (HealthDay News) -- The long-term risk of cancer after a kidney transplant does not vary among three different immunosuppressive regimens, according to a study published online April 29 in the Journal of the American Society of Nephrology.

Martin P. Gallagher, M.D., of the George Institute for International Health in Camperdown, Australia, and colleagues randomized 489 first cadaveric renal transplant recipients to receive either azathioprine and prednisolone; long-term cyclosporine monotherapy; or short-term cyclosporine monotherapy followed by withdrawal and maintenance azathioprine and prednisolone. The measured outcome was incident cases of skin cancer and incident cases of non-skin cancer, including incident melanoma in the latter group.

Out of 481 patients over a median follow-up of 20.6 years, the researchers found that 226 developed at least one cancer (95 with non-skin cancer and 171 with skin cancer). In an intention-to-treat analysis, the mean times to first skin cancer and first non-skin cancer were not found to be different among the three treatment groups. The investigstors also found associations between non-skin cancer and increasing age and smoking history; incidence of skin cancer was associated with increasing age, lighter skin, non-brown eyes, and a functioning transplant.

"Our data suggest that azathioprine- and cyclosporine-based regimens are associated with similar overall long-term cancer risks, suggesting that the risk may be mediated by the total burden of immunosuppression more than the agent," the authors write.

The study was supported by Sandoz out to 10 years of follow-up. Three study authors disclosed financial ties to pharmaceutical companies that make immunosuppressive agents.

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