The risk of neoplasms in patients treated with cyclosporine A

Immunosuppressive therapy (IT) carries inherent risks involving the occurrence of lymphoproliferative disorders and malignancies (MA). The most frequently observed neoplasms in organ-transplant (OT) recipients treated with cyclosporine A (Cy-A) involve the skin and the lympho-reticular system. A disproportionally high percentage of the skin MA are Kaposi's sarcoma. Compared with a normal, not-exposed population matched for age, sex and country; Cy-A-treated OT recipients have a 28-times higher prevalence of lymphomas. This figure compares with a 34 to 59-fold increased risk in patients receiving conventional immunosuppressive therapy (CIT) for OT. However, it appears that in Cy-A-treated patients the latency period for the development of lymphomas is shorter than in patients on CIT. Other MA are increased seven-fold in Cy-A-treated patients and between two- and six-fold in those receiving CIT. The overall incidence of all types of MA is increased two-fold for Cy-A recipients and between two- and four-fold for those on CIT. Therefore patients receiving IT should be carefully monitored with respect to the possible occurrence of neoplasms.