Treatment of metastatic transitional cell carcinoma following renal transplantation

Renal transplantation was performed in a patient with a history of surgical excision for localized transitional cell carcinoma. The graft functioned well; however, metastatic transitional cell carcinoma developed following transplantation. The patient was treated sequentially with CISCA (cisplatin, Cytoxan [cyclophosphamide], and Adriamycin [doxorubicin hydrochloride]) and M-VAC (methotrexate, vinblastine, Adriamycin, and cisplatin) with no alteration in maintenance immunosuppression. Full-dose chemotherapy was well tolerated, with no impairment of renal function, and a demonstrable reduction in tumor burden was achieved. The patient ultimately died of metastatic disease but enjoyed an excellent quality of life throughout the post-transplant period.