COMPLICATIONS - MALIGNANCY

K. Harzallah¹, M. Cherif², S. Yaich³, H. Skhiri⁴, E. Abderrahim⁵, K. Chareffedine³, F. El younsi⁵, T. Ben abdallah⁵, J. Hamida⁶, A. Achour⁷, M. El may⁴, J. Manaa¹, J. Hachicha³, A. Kheder^5
1Unity Of Organ Transplantation, Military Hospital of Tunis, 1008/TUNISIA, ²Department Of Nephrology, charles nicolle, 1080/TUNISIA, ³Nephrology, Hedi Chaker Hospital, 7000/TUNISIA, ⁴Nephrology, Fattouma Bourguiba Hospital, 5000/TUNISIA, ⁵Nephrology, charles nicolle, 1080/TUNISIA, ⁶Unity Of Organ Transplantation, Military Hospitak of Tunis, 1008/TUNISIA, ⁷Nephrology, Sahloul Hospital, 3000/TUNISIA

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Introduction: Renal transplant recipients are at higher risk of certain tumors such as lymphomas and skin cancers than the general and dialysis populations. Methods: We retrospectively studied the prevalence of tumors in adult renal transplant recipients in five Tunisian centers of transplantation in Tunis, Monastir, sousse and Sfax from January 1986 to January 2008. Results: The study included 52 patients; 32 men and 20 women with a mean age of 36 years (range from 18-54 years). The mean time since dialysis to transplantation was 46 months (20-236 months). Induction therapy was based on thymoglobulin in 100 % and administered in a mean course of 12.4 days in 82,2 % of the patients. Maintenance therapy was based on calcineurin inhibitors (CNI) in 91,2 % of cases, on antimetabolites and corticosteroids in 100 % of cases. Acute rejection occurred in 36 of these cases and was treated with polyclonal or monoclonal antibodies on 40 % of cases. Incidence of cancer among our population was 6,6 % and occurred after a mean period of 55,4 months of transplantation for solid tumors and 99 months for skin tumors. Eighty three percent of the tumors were solid, and the rest were in the skin. Kaposi sarcoma formed 58.6 % and non-Hodgkin or Hodgkin lymphoma 21.7 % of the solid tumors, while spinocellular carcinoma formed 83% and basocellular carcinoma 17% of the skin tumors. Switching CNI to sirolimus in 8.3% cases was associated with a favorable outcome. Mortality was the outcome in 28.3% of the patients with cancer, while partial or complete regression of cancers was observed in 54.7% cases after decreasing the doses of the immunosuppressive medications. Conclusion: We conclude that post renal transplant cancer is mainly characterized by the predominance of Kaposi sarcoma favored by solar exposure and excessive Induction and maintenance immunosuppression. Careful follow-up may results in early intervention and decrease mortality

Disclosure: All authors have declared no conflicts of interest.