Temporal Trends of De Novo Malignancy Development After Heart Transplantation

Jong Chan Youn, Josef Stehlik, Amber R. Wilk, Wida Cherikh, In Cheol Kim, Gyeong Hun Park, Lars H. Lund, Howard J. Eisen, Do Young Kim, Sun Ki Lee, Suk Won Choi, Seongwoo Han, Kyu Hyung Ryu, seokmin kang, Jon A. Kobashigawa

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Malignancy is a concern in cardiac transplant recipients, but the temporal trends of de novo malignancy development are unknown. Objectives The goal of this study was to describe the temporal trends of the incidence, types, and predictors of de novo malignancy in cardiac transplant recipients. Methods The authors analyzed the temporal trends of post-transplant incidence, types, and predictors of malignancy using 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry. The main study outcomes included the incidence of, types of, and time to de novo malignancy. Results The risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7%. The cumulative incidence by malignancy type was: skin cancer (7.0%), non-skin solid cancer (4.0%), and lymphoproliferative disorders (0.9%). There was no temporal difference in the time to development according to malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000 to 2005 vs. 2006 to 2011 (10.0% vs. 12.4%; p < 0.0001). Survival in patients after de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). Older recipients and patients who underwent transplantation in the recent era had a higher risk of de novo malignancy. Conclusions More than 10% of adult heart transplant recipients developed de novo malignancy between years 1 and 5 after transplantation, and this outcome was associated with increased mortality. The incidence of post-transplant de novo solid malignancy increased temporally, with the largest increase in skin cancer. Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy.

Original languageEnglish
Pages (from-to)40-49
Number of pages10
JournalJournal of the American College of Cardiology
Volume71
Issue number1
DOIs
Publication statusPublished - 2018 Jan 2

Fingerprint

Heart Transplantation
Neoplasms
Incidence
Transplantation
Skin Neoplasms
Transplants
Lymphoproliferative Disorders
Early Detection of Cancer
Immunosuppression
Registries

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Youn, J. C., Stehlik, J., Wilk, A. R., Cherikh, W., Kim, I. C., Park, G. H., ... Kobashigawa, J. A. (2018). Temporal Trends of De Novo Malignancy Development After Heart Transplantation. Journal of the American College of Cardiology, 71(1), 40-49. https://doi.org/10.1016/j.jacc.2017.10.077
Youn, Jong Chan ; Stehlik, Josef ; Wilk, Amber R. ; Cherikh, Wida ; Kim, In Cheol ; Park, Gyeong Hun ; Lund, Lars H. ; Eisen, Howard J. ; Kim, Do Young ; Lee, Sun Ki ; Choi, Suk Won ; Han, Seongwoo ; Ryu, Kyu Hyung ; kang, seokmin ; Kobashigawa, Jon A. / Temporal Trends of De Novo Malignancy Development After Heart Transplantation. In: Journal of the American College of Cardiology. 2018 ; Vol. 71, No. 1. pp. 40-49.
@article{b7e3162e93de4c1798346e9549bdcaee,
title = "Temporal Trends of De Novo Malignancy Development After Heart Transplantation",
abstract = "Background Malignancy is a concern in cardiac transplant recipients, but the temporal trends of de novo malignancy development are unknown. Objectives The goal of this study was to describe the temporal trends of the incidence, types, and predictors of de novo malignancy in cardiac transplant recipients. Methods The authors analyzed the temporal trends of post-transplant incidence, types, and predictors of malignancy using 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry. The main study outcomes included the incidence of, types of, and time to de novo malignancy. Results The risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7{\%}. The cumulative incidence by malignancy type was: skin cancer (7.0{\%}), non-skin solid cancer (4.0{\%}), and lymphoproliferative disorders (0.9{\%}). There was no temporal difference in the time to development according to malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000 to 2005 vs. 2006 to 2011 (10.0{\%} vs. 12.4{\%}; p < 0.0001). Survival in patients after de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). Older recipients and patients who underwent transplantation in the recent era had a higher risk of de novo malignancy. Conclusions More than 10{\%} of adult heart transplant recipients developed de novo malignancy between years 1 and 5 after transplantation, and this outcome was associated with increased mortality. The incidence of post-transplant de novo solid malignancy increased temporally, with the largest increase in skin cancer. Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy.",
author = "Youn, {Jong Chan} and Josef Stehlik and Wilk, {Amber R.} and Wida Cherikh and Kim, {In Cheol} and Park, {Gyeong Hun} and Lund, {Lars H.} and Eisen, {Howard J.} and Kim, {Do Young} and Lee, {Sun Ki} and Choi, {Suk Won} and Seongwoo Han and Ryu, {Kyu Hyung} and seokmin kang and Kobashigawa, {Jon A.}",
year = "2018",
month = "1",
day = "2",
doi = "10.1016/j.jacc.2017.10.077",
language = "English",
volume = "71",
pages = "40--49",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "1",

}

Youn, JC, Stehlik, J, Wilk, AR, Cherikh, W, Kim, IC, Park, GH, Lund, LH, Eisen, HJ, Kim, DY, Lee, SK, Choi, SW, Han, S, Ryu, KH, kang, S & Kobashigawa, JA 2018, 'Temporal Trends of De Novo Malignancy Development After Heart Transplantation', Journal of the American College of Cardiology, vol. 71, no. 1, pp. 40-49. https://doi.org/10.1016/j.jacc.2017.10.077

Temporal Trends of De Novo Malignancy Development After Heart Transplantation. / Youn, Jong Chan; Stehlik, Josef; Wilk, Amber R.; Cherikh, Wida; Kim, In Cheol; Park, Gyeong Hun; Lund, Lars H.; Eisen, Howard J.; Kim, Do Young; Lee, Sun Ki; Choi, Suk Won; Han, Seongwoo; Ryu, Kyu Hyung; kang, seokmin; Kobashigawa, Jon A.

In: Journal of the American College of Cardiology, Vol. 71, No. 1, 02.01.2018, p. 40-49.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Temporal Trends of De Novo Malignancy Development After Heart Transplantation

AU - Youn, Jong Chan

AU - Stehlik, Josef

AU - Wilk, Amber R.

AU - Cherikh, Wida

AU - Kim, In Cheol

AU - Park, Gyeong Hun

AU - Lund, Lars H.

AU - Eisen, Howard J.

AU - Kim, Do Young

AU - Lee, Sun Ki

AU - Choi, Suk Won

AU - Han, Seongwoo

AU - Ryu, Kyu Hyung

AU - kang, seokmin

AU - Kobashigawa, Jon A.

PY - 2018/1/2

Y1 - 2018/1/2

N2 - Background Malignancy is a concern in cardiac transplant recipients, but the temporal trends of de novo malignancy development are unknown. Objectives The goal of this study was to describe the temporal trends of the incidence, types, and predictors of de novo malignancy in cardiac transplant recipients. Methods The authors analyzed the temporal trends of post-transplant incidence, types, and predictors of malignancy using 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry. The main study outcomes included the incidence of, types of, and time to de novo malignancy. Results The risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7%. The cumulative incidence by malignancy type was: skin cancer (7.0%), non-skin solid cancer (4.0%), and lymphoproliferative disorders (0.9%). There was no temporal difference in the time to development according to malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000 to 2005 vs. 2006 to 2011 (10.0% vs. 12.4%; p < 0.0001). Survival in patients after de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). Older recipients and patients who underwent transplantation in the recent era had a higher risk of de novo malignancy. Conclusions More than 10% of adult heart transplant recipients developed de novo malignancy between years 1 and 5 after transplantation, and this outcome was associated with increased mortality. The incidence of post-transplant de novo solid malignancy increased temporally, with the largest increase in skin cancer. Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy.

AB - Background Malignancy is a concern in cardiac transplant recipients, but the temporal trends of de novo malignancy development are unknown. Objectives The goal of this study was to describe the temporal trends of the incidence, types, and predictors of de novo malignancy in cardiac transplant recipients. Methods The authors analyzed the temporal trends of post-transplant incidence, types, and predictors of malignancy using 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry. The main study outcomes included the incidence of, types of, and time to de novo malignancy. Results The risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7%. The cumulative incidence by malignancy type was: skin cancer (7.0%), non-skin solid cancer (4.0%), and lymphoproliferative disorders (0.9%). There was no temporal difference in the time to development according to malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000 to 2005 vs. 2006 to 2011 (10.0% vs. 12.4%; p < 0.0001). Survival in patients after de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). Older recipients and patients who underwent transplantation in the recent era had a higher risk of de novo malignancy. Conclusions More than 10% of adult heart transplant recipients developed de novo malignancy between years 1 and 5 after transplantation, and this outcome was associated with increased mortality. The incidence of post-transplant de novo solid malignancy increased temporally, with the largest increase in skin cancer. Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy.

UR - http://www.scopus.com/inward/record.url?scp=85038362562&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038362562&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2017.10.077

DO - 10.1016/j.jacc.2017.10.077

M3 - Article

VL - 71

SP - 40

EP - 49

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 1

ER -