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Updated: Apr 17, 2026
A Human Peripheral Blood Mononuclear Cell PBMC Engrafted Humanized Xenograft Model for Translational Immuno-oncology I-O Research
Published on: August 15, 2019
Immune profiling and cancer post transplantation
Christopher Martin Hope1, Patrick Toby H Coates1, Robert Peter Carroll1
1Christopher Martin Hope, Patrick Toby H Coates, Robert Peter Carroll, Centre for Clinical and Experimental Transplantation, Central Northern Adelaide Renal and Transplantation Services, Adelaide SA 5000, Australia.
Abstract:
Half of all long-term (> 10 year) australian kidney transplant recipients (KTR) will develop squamous cell carcinoma (SCC) or solid organ cancer (SOC), making cancer the leading cause of death with a functioning graft. At least 30% of KTR with a history of SCC or SOC will develop a subsequent SCC or SOC lesion. Pharmacological immunosuppression is a major contributor of the increased risk of cancer for KTR, with the cancer lesions themselves further adding to systemic immunosuppression and could explain, in part, these phenomena. Immune profiling includes; measuring immunosuppressive drug levels and pharmacokinetics, enumerating leucocytes and leucocyte subsets as well as testing leucocyte function in either an antigen specific or non-specific manner. Outputs can vary from assay to assay according to methods used. In this review we define the rationale behind post-transplant immune monitoring assays and focus on assays that associate and/or have the ability to predict cancer and rejection in the KTR. We find that immune monitoring can identify those KTR of developing multiple SCC lesions and provide evidence they may benefit from pharmacological immunosuppressive drug dose reductions. In these KTR risk of rejection needs to be assessed to determine if reduction of immunosuppression will not harm the graft.
Insights
Kidney transplant recipients face high cancer risks, with immune monitoring identifying those who may benefit from reduced immunosuppression. Careful assessment is needed to balance cancer risk reduction with graft rejection prevention.
Area of Science:
- Nephrology
- Oncology
- Immunology
Background:
- Long-term kidney transplant recipients (KTR) have a high incidence of squamous cell carcinoma (SCC) and other cancers, which are leading causes of death.
- Pharmacological immunosuppression significantly contributes to increased cancer risk in KTR.
- Cancer lesions can exacerbate systemic immunosuppression in KTR.
Purpose of the Study:
- To review the rationale for post-transplant immune monitoring assays.
- To identify assays that can predict cancer and rejection in KTR.
- To explore the potential for immune monitoring to guide immunosuppression reduction.
Main Methods:
- Review of existing literature on immune monitoring in kidney transplant recipients.
- Analysis of assays measuring immunosuppressive drug levels, pharmacokinetics, and leukocyte function.
- Focus on assays correlating with cancer development and graft rejection.
Main Results:
- Immune monitoring can identify KTR at high risk for developing multiple SCC lesions.
- Evidence suggests that some KTR may benefit from reduced immunosuppressive drug doses.
- Assessing rejection risk is crucial before reducing immunosuppression.
Conclusions:
- Immune monitoring is valuable for managing cancer risk in KTR.
- Personalized immunosuppression management can potentially reduce cancer incidence.
- Balancing immunosuppression reduction with graft survival is paramount.
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