Organ transplantation increases risk of non-Hodgkin lymphoma (NHL), but long-term risk and time trends have seldom been evaluated. Immunosuppressive drug load is an important risk determinant, but the details are unclear. We studied NHL risk in a nationwide Swedish cohort of 11 081 graft recipients transplanted 1970-2008. Relative risks (RRs) were estimated within the cohort and versus the general population by age, sex, follow-up time and calendar period. NHL risk was also assessed by cumulative and average doses of immunosuppressive treatments in a nested case-control design throughout 1997 using conditional logistic regression. We observed 153 NHL cases during 97 853 years of follow-up. Compared with the general population, NHL risk was eightfold increased (RR 7.9; 95% confidence interval [CI] 6.6-9.4), and increased risks persisted after ≥15 years of follow-up among kidney (6.1; 95% CI 3.5-10) and nonkidney recipients (44; 14-103). Among nonkidney recipients, NHL risk was lower in the 2000s compared with the 1990s (0.5; 95% CI 0.3-1.0; p = 0.04). A high average dose of antithymocyte immunoglobulin (ATG) conferred an eightfold increased risk of NHL (OR 8.5; 95% CI 1.9-38). To conclude, posttransplant NHL risk decreased during the last decade among nonkidney recipients, possibly because of a more careful use of ATG, the introduction of new drugs, or both

Fernberg, P., Edgren, G., Adami, J., Ingvar, A., Bellocco, R., Tufveson, G., et al. (2011). Time trends in risk and risk determinants of non-hodgkin lymphoma in solid organ transplant recipients. AMERICAN JOURNAL OF TRANSPLANTATION, 11(11), 2472-2482 [10.1111/j.1600-6143.2011.03704.x].

Time trends in risk and risk determinants of non-hodgkin lymphoma in solid organ transplant recipients

BELLOCCO, RINO;
2011

Abstract

Organ transplantation increases risk of non-Hodgkin lymphoma (NHL), but long-term risk and time trends have seldom been evaluated. Immunosuppressive drug load is an important risk determinant, but the details are unclear. We studied NHL risk in a nationwide Swedish cohort of 11 081 graft recipients transplanted 1970-2008. Relative risks (RRs) were estimated within the cohort and versus the general population by age, sex, follow-up time and calendar period. NHL risk was also assessed by cumulative and average doses of immunosuppressive treatments in a nested case-control design throughout 1997 using conditional logistic regression. We observed 153 NHL cases during 97 853 years of follow-up. Compared with the general population, NHL risk was eightfold increased (RR 7.9; 95% confidence interval [CI] 6.6-9.4), and increased risks persisted after ≥15 years of follow-up among kidney (6.1; 95% CI 3.5-10) and nonkidney recipients (44; 14-103). Among nonkidney recipients, NHL risk was lower in the 2000s compared with the 1990s (0.5; 95% CI 0.3-1.0; p = 0.04). A high average dose of antithymocyte immunoglobulin (ATG) conferred an eightfold increased risk of NHL (OR 8.5; 95% CI 1.9-38). To conclude, posttransplant NHL risk decreased during the last decade among nonkidney recipients, possibly because of a more careful use of ATG, the introduction of new drugs, or both
Articolo in rivista - Articolo scientifico
Non-Hodgkin Lymphoma, Immnunosuppression,
English
2011
11
11
2472
2482
none
Fernberg, P., Edgren, G., Adami, J., Ingvar, A., Bellocco, R., Tufveson, G., et al. (2011). Time trends in risk and risk determinants of non-hodgkin lymphoma in solid organ transplant recipients. AMERICAN JOURNAL OF TRANSPLANTATION, 11(11), 2472-2482 [10.1111/j.1600-6143.2011.03704.x].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/26832
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