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脏移植后的癌症:来自意大利单一中心的现实世界追溯分析
Giulia Vanessa Re Sartò1, Carlo Alfieri2,3, Laura Cosmai1
1Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy.
概括
癌症是移植 (KTx) 后的一个重大风险. 反甲基球蛋白 (ATG) 诱导疗法与癌症风险增加有关,而切换到mTOR抑制剂可以改善癌症后的生存率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 癌症是移植接受者 (KTRs) 的一个主要并发症.
- 了解癌症风险因素和癌症后管理对于KTR生存至关重要.
研究的目的:
- 调查癌症流行病学,风险因素以及免疫抑制疗法修改对KTRs生存的影响.
- 分析特定免疫抑制药物与癌症发展之间的关联.
- 评估癌症诊断后改变免疫抑制策略对患者结局的影响.
主要方法:
- 对930个KTR进行回顾性分析,随访时间中位数为7年.
- 收集有关人口统计,移植细节,免疫抑制疗法和癌症发病率的数据.
- 统计分析包括生存和竞争风险分析,以确定风险因素和治疗影响.
主要成果:
- 19%的KTR患有癌症,非黑色素瘤皮肤癌 (NMSC) 是最常见的.
- 与巴西力西马布相比,抗血球球蛋白 (ATG) 诱导疗法独立地与更高的癌症风险和更早的癌症发展有关.
- 在癌症诊断后切换为mTOR抑制剂的患者的生存结果明显好于停止免疫抑制治疗的患者.
结论:
- 在KTRs中,ATG是癌症的独立风险因素.
- 在移植时选择个性化免疫抑制疗法对于预防癌症至关重要.
- 在癌症诊断后切换到mTOR抑制剂是一种有前途的策略,可以提高KTR存活率.
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