Plasma cell neoplasms in US solid organ transplant recipients

Area of Science:

• Oncology
• Immunology
• Transplantation Medicine

Background:

• Transplant recipients exhibit an increased risk for plasma cell neoplasms (PCNs), including multiple myeloma and plasmacytoma.
• Risk factors for PCNs in the context of organ transplantation remain largely unexplored.

Purpose of the Study:

• To investigate risk factors associated with plasma cell neoplasms (PCNs) in solid organ transplant recipients.
• To determine the incidence and specific types of PCNs post-transplantation.

Main Methods:

• Utilized linkage between the US solid organ transplant registry and 15 state/regional cancer registries.
• Identified 140 PCNs among 202,600 transplant recipients between 1987 and 2009.
• Calculated standardized incidence ratios (SIRs) comparing transplant recipients to the general population.

Main Results:

• PCN risk was 1.8-fold higher in transplant recipients versus the general population (SIR 1.80).
• Plasmacytoma showed a significantly higher risk (SIR 7.06) compared to multiple myeloma (SIR 1.41).
• Elevated risk was observed in EBV-seronegative recipients (SIR 3.93) and liver transplant recipients with cholestatic liver disease (SIR 2.78), including primary biliary cirrhosis (PBC).

Conclusions:

• Transplantation is associated with an increased risk of PCNs, particularly plasmacytoma.
• Epstein-Barr virus (EBV) seronegativity and cholestatic liver disease (e.g., PBC) are potential risk factors for PCNs post-transplantation.
• Primary EBV infection post-transplant may contribute to PCN development, alongside chronic immune activation in conditions like PBC.