1 in 10 Heart Transplant Pts Develops De Novo Solid Malignancy

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Higher mortality for heart transplant patients with de novo solid malignancy than those without malignancy.
Higher mortality for heart transplant patients with de novo solid malignancy than those without malignancy.

(HealthDay News) -- More than 1 in 10 adult heart transplant recipients develop de novo malignancy between 1 and 5 years after transplantation, and this is associated with increased mortality, according to a study published in the Journal of the American College of Cardiology.

Jong-Chan Youn, MD, PhD, from the Hallym University College of Medicine in Hwaseong, South Korea, and colleagues examined temporal trends of post-transplant incidence, types, and predictors of malignancy using data for 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry.

The researchers found that the risk of developing any de novo solid malignancy was 10.7% between one and five years after transplantation. By malignancy type, the cumulative incidence was 7, 4, and 0.9% for skin cancer, non-skin solid cancer, and lymphoproliferative disorders, respectively. No temporal difference was seen in the time to development according to malignancy type. From 2000-2005 to 2006-2011, the cumulative incidence of de novo solid malignancy increased from 10 to 12.4% (P<0.0001). Markedly lower survival was seen for patients after de novo malignancy versus no malignancy (P<0.0001). The risk of de novo malignancy was higher for older recipients and patients who underwent transplantation in the recent era.

"Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy," the authors write.

Two authors disclosed financial ties to the medical device and pharmaceutical industries.

References

Youn JC, Stehlik J, Wilk AR, Cherikh W, et al. Temporal Trends of De Novo Malignancy Development After Heart Transplantation. J Am Coll Cardiol 2018;71,1 doi:10.1016/j.jacc.2017.10.077

Mancini D and Rakita V. Malignancy Post Heart Transplantation. J Am Coll Cardiol 2018;71,1. doi:10.1016/j.jacc.2017.11.027

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