Tom[a]
Gliomas following organ transplantation: a tumor registry analysis
David Schiff, Thomas Beebe, Steve Woodle, Roy First, Joseph Buell, University of Virginia Health Science Center, Charlottesville, VA; University of Cincinnati Medical Center, Cincinnati, OH.
We have previously reported a series of patients developing glial brain tumors following solid organ transplantation (Neurology 2001;57:1486-1488). An association between human immunodeficiency virus and subsequent glioma development has also been observed, suggesting immunosuppression may be a risk factor for gliomagenesis. To explore the putative association between organ transplantation and glioma development, we reviewed data accumulated by the Israel Penn International Transplant Tumor Registry (IPITTR) over a 15 year period and compared it to predicted number of cancer cases in the U.S. in 2001 per American Cancer Society estimates to assess the relative incidence of gliomas compared to other malignancies. Of the 7256 malignancies in the IPITTR database, 19 (0.3%) were primary brain tumors. Fourteen were gliomas, including six glioblastomas, three anaplastic astrocytomas, four astrocytomas, and one oligodendroglioma. The ratio of all expected cancer cases in the United States in 2001 to the number of cases in the IPITTR was 175:1. The ratio was substantially lower in malignancies known to occur with increased frequency in transplant recipients (kidney cancer was 92:1, sarcoma 108:1, and vulvar/vaginal cancer 78:1). The ratio for brain tumors was 905:1. Other malignancies not known to be overrepresented in transplant recipients had similar ratios (ovarian cancer 807:1, pancreatic cancer 942:1, lung cancer 494:1, and colon cancer were 498:1, 942:1, 494:1, and 498:1). None of the six cases we previously reported had been reported to the IPITTR. Primary brain tumors, including gliomas, do not appear to be over-represented in the IPITTR, suggesting that they do not arise with increased frequency in transplant recipients. However, we cannot exclude the possibility that neuro-oncologists have underreported to this voluntary tumor registry.
Source: ASCO