The Effect of Immunosuppression on Cancer - "In 16 instances (13%) the neoplasms made their appearance within the first 4 months after transplantation"
(1972)
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Some interesting stats, even though the paper is 50 years old.
Immunosuppressive drugs were much more aggressive back then, not antirejection specific, and many of these would have been pre-existing microtumors, but it does go to show how incredibly fast a neoplasm can develop if unconstrained by the immune system. 4 months Vs 40 years say.
Mesenchymal: (meh-ZEN-kih-mul) Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue.
“Since 1948 when Farber and his colleagues17 introduced aminopterin in the treatment of acute leukemia of childhood, the field of cancer chemotherapy has grown spectacularly. Today, a vast selection of drugs are available to treat every variety of cancer. One of the effects of many of these agents is impairment of antibody synthesis and cell mediated immunity. These immunosuppressive effects have been used therapeutically to prevent and control rejection of organ transplants. The immunosuppressive agents have also been used to treat a variety of clinical states including chronic hepatitis, ulcerative colitis, Crohn’s disease, glomerulonephritis, sarcoidosis, bronchial asthma, uveitis, rheumatoid arthritis, psoriasis and other chronic skin diseases.
Apart from their cytotoxic side effects the cancer chemotherapeutic agents have direct or indirect mutagenic, teratogenic and oncogenic effects. These have been frequently demonstrated in experimental animals and in lower forms of life.4, 7, 16, 30, 32, 33, 35, 58, 60, 75 The present report is concerned with their potential oncogenic properties in man. Evidence has been accumulated from three groups of patients: 1) Organ transplant recipients treated with immunosuppressive compounds; 2) Patients with a variety of nonmalignant diseases treated with immunosuppressive agents; 3) Patients with malignancies who received cancer chemotherapy.”
“In previous reports49–52, 68 we have indicated that an organ transplant recipient maintained on chronic immunosuppressive therapy has a 5 to 6% chance of developing a malignant tumor. This risk is approximately 100 times greater than in individuals in the general population in the same age range.
…The 122 patients had 125 types of tumor of which 76 were of epithelial origin (61%) and 49 (39%) were mesenchymal. The most common epithelial lesions were various skin cancers (27 cases—36%), carcinomas of the cervix (11 cases—14 %) and carcinomas of the lip (11 cases—14 %). The most common mesenchymal tumors were various types of solid lymphoma (42 cases—86%) of which the most prominent group were the reticulum cell sarcomas (30 cases—61%). A most unusual feature of the lymphomas was their predilection for the central nervous system which occurred in 20 of 41 cases (49%). In 17 instances (41%) the central nervous system was the only area affected. These figures contrast with a 0.04% to 1.5% involvement of the central nervous system in two large series.”
“The cancers generally occurred in young people (average age 36, range 8 to 70 years) of which 37% were over the age of 40 years. The average time of appearance of the tumors following transplantation was 28 months (range 1 to 92 months). In 16 instances (13%) the neoplasms made their appearance within the first 4 months after transplantation. It is possible that at least some of these tumors or even some of those with a later appearance were already present at the time of transplantation, but were small and undetected, and grew rapidly under the influence of the immunosuppressive therapy.”
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