Cumulative Doses of T-Cell Depleting Antibody and Cancer Risk after Kidney Transplantation

PLoS One. 2015 Nov 10;10(11):e0139479. doi: 10.1371/journal.pone.0139479. eCollection 2015.

Abstract

T-cell depleting antibody is associated with an increased risk of cancer after kidney transplantation, but a dose-dependent relationship has not been established. This study aimed to determine the association between cumulative doses of T-cell depleting antibody and the risk of cancer after kidney transplantation. Using data from the Australian and New Zealand Dialysis and Transplant Registry between 1997-2012, we assessed the risk of incident cancer and cumulative doses of T-cell depleting antibody using adjusted Cox regression models. Of the 503 kidney transplant recipients with 2835 person-years of follow-up, 276 (55%), 209 (41%) and 18 (4%) patients received T-cell depleting antibody for induction, rejection or induction and rejection respectively. The overall cancer incidence rate was 1,118 cancers per 100,000 patient-years, with 975, 1093 and 1377 cancers per 100,000 patient-years among those who had received 1-5 doses, 6-10 doses and >10 doses, respectively. There was no association between cumulative doses of T cell depleting antibody and risk of incident cancer (1-5: referent, 6-10: adjusted hazard ratio (HR) 1.19, 95%CI 0.48-2.95, >10: HR 1.42, 95%CI 0.50-4.02, p = 0.801). This lack of association is contradictory to our hypothesis and is likely attributed to the low event rates resulting in insufficient power to detect significant differences.

MeSH terms

  • Adult
  • Antilymphocyte Serum / administration & dosage
  • Antilymphocyte Serum / adverse effects*
  • Australia / epidemiology
  • Dose-Response Relationship, Immunologic
  • Female
  • Graft Rejection / prevention & control
  • Graft Rejection / therapy
  • Humans
  • Immunocompromised Host
  • Incidence
  • Kidney Transplantation*
  • Lymphocyte Depletion / adverse effects*
  • Lymphocyte Depletion / methods
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Neoplasms / etiology*
  • Neoplasms / immunology
  • New Zealand / epidemiology
  • Proportional Hazards Models
  • T-Lymphocytes / immunology*

Substances

  • Antilymphocyte Serum