Journal article
Cancer Risk After Pediatric Solid Organ Transplantation
Pediatrics (Evanston), Vol.139(5), p.e20163893
05/2017
DOI: 10.1542/peds.2016-3893
PMCID: PMC5404730
PMID: 28557749
Abstract
The effects of pediatric solid organ transplantation on cancer risk may differ from those observed in adult recipients. We described cancers in pediatric recipients and compared incidence to the general population.
The US transplant registry was linked to 16 cancer registries to identify cancer diagnoses among recipients <18 years old at transplant. Standardized incidence ratios (SIRs) were estimated by dividing observed cancer counts among recipients by expected counts based on the general population rates. Cox regression was used to estimate the associations between recipient characteristics and non-Hodgkin's lymphoma (NHL) risk.
Among 17 958 pediatric recipients, 392 cancers were diagnosed, of which 279 (71%) were NHL. Compared with the general population, incidence was significantly increased for NHL (SIR = 212, 95% confidence interval [CI] = 188-238), Hodgkin's lymphoma (SIR = 19, 95% CI = 13-26), leukemia (SIR = 4, 95% CI = 2-7), myeloma (SIR = 229, 95% CI = 47-671), and cancers of the liver, soft tissue, ovary, vulva, testis, bladder, kidney, and thyroid. NHL risk was highest during the first year after transplantation among recipients <5 years old at transplant (SIR = 313), among recipients seronegative for Epstein-Barr virus (EBV) at transplant (SIR = 446), and among intestine transplant recipients (SIR = 1280). In multivariable analyses, seronegative EBV status, the first year after transplantation, intestine transplantation, and induction immunosuppression were independently associated with higher NHL incidence.
Pediatric recipients have a markedly increased risk for many cancers. NHL constitutes the majority of diagnosed cancers, with the highest risk occurring in the first year after transplantation. NHL risk was high in recipients susceptible to primary EBV infection after transplant and in intestine transplant recipients, perhaps due to EBV transmission in the donor organ.
Details
- Title: Subtitle
- Cancer Risk After Pediatric Solid Organ Transplantation
- Creators
- Elizabeth L Yanik - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland; yanike@wudosis.wustl.eduJodi M Smith - University of WashingtonMeredith S Shiels - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MarylandChristina A Clarke - Cancer Prevention Institute of California, Fremont, CaliforniaCharles F Lynch - Department of Epidemiology, University of Iowa, Iowa City, IowaAmy R Kahn - New York State Cancer Registry, Albany, New YorkLori Koch - Illinois State Cancer Registry, Springfield, Illinois; andKaren S Pawlish - New Jersey State Cancer Registry, Trenton, New JerseyEric A Engels - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.139(5), p.e20163893
- DOI
- 10.1542/peds.2016-3893
- PMID
- 28557749
- PMCID
- PMC5404730
- NLM abbreviation
- Pediatrics
- ISSN
- 1098-4275
- eISSN
- 1098-4275
- Publisher
- American Academy of Pediatrics; United States
- Grant note
- P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995133902771
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