Polyomavirus Replication and Smoking Are Independent Risk Factors for Bladder Cancer After Renal Transplantation

Solid organ transplant recipients are at increased risk for developing malignancies. Polyomaviruses (PV) have been historically associated with experimental tumor development and recently described in association with renourinary malignancies in transplant patients. The aim of this study was to inve...

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Published inTransplantation Vol. 101; no. 6; p. 1488
Main Authors Liu, Sandy, Chaudhry, Muhammad R, Berrebi, Alexander A, Papadimitriou, John C, Drachenberg, Cinthia B, Haririan, Abdolreza, Alexiev, Borislav A
Format Journal Article
LanguageEnglish
Published United States 01.06.2017
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Abstract Solid organ transplant recipients are at increased risk for developing malignancies. Polyomaviruses (PV) have been historically associated with experimental tumor development and recently described in association with renourinary malignancies in transplant patients. The aim of this study was to investigate the relationship between PV replication and smoking, and the development of malignant neoplasms in kidney transplant recipients. A retrospective case-control study was conducted for PV replication in all kidney biopsies and urine cytologies performed between 1998 and 2014 from kidney transplant recipients at the University of Maryland Medical Center. Polyomavirus-positive patients (n = 943) were defined as having any of the following: a kidney biopsy with PV associated nephropathy, any urine cytology demonstrating "decoy" cells, and/or significant polyomavirus BK viremia. Polyomavirus-negative matched patients (n = 943) were defined as lacking any evidence of PV replication. The incidence of malignancy (excluding nonmelanoma skin tumors) was determined in these 1886 patients and correlated with demographic data and history of smoking. There was a 7.9% incidence of malignant tumors after a mean posttransplant follow-up of 7.9 ± 5.4 years. Among all cancer subtypes, only bladder carcinoma was significantly associated with PV replication. By multivariate analysis, only PV replication and smoking independently increased the risk of bladder cancer, relative risk, 11.7 (P = 0.0013) and 5.6 (P = 0.0053), respectively. The findings in the current study indicate that kidney transplant recipients with PV replication and smoking are at particular risk to develop bladder carcinomas and support the need for long-term cancer surveillance in these patients.
AbstractList Solid organ transplant recipients are at increased risk for developing malignancies. Polyomaviruses (PV) have been historically associated with experimental tumor development and recently described in association with renourinary malignancies in transplant patients. The aim of this study was to investigate the relationship between PV replication and smoking, and the development of malignant neoplasms in kidney transplant recipients. A retrospective case-control study was conducted for PV replication in all kidney biopsies and urine cytologies performed between 1998 and 2014 from kidney transplant recipients at the University of Maryland Medical Center. Polyomavirus-positive patients (n = 943) were defined as having any of the following: a kidney biopsy with PV associated nephropathy, any urine cytology demonstrating "decoy" cells, and/or significant polyomavirus BK viremia. Polyomavirus-negative matched patients (n = 943) were defined as lacking any evidence of PV replication. The incidence of malignancy (excluding nonmelanoma skin tumors) was determined in these 1886 patients and correlated with demographic data and history of smoking. There was a 7.9% incidence of malignant tumors after a mean posttransplant follow-up of 7.9 ± 5.4 years. Among all cancer subtypes, only bladder carcinoma was significantly associated with PV replication. By multivariate analysis, only PV replication and smoking independently increased the risk of bladder cancer, relative risk, 11.7 (P = 0.0013) and 5.6 (P = 0.0053), respectively. The findings in the current study indicate that kidney transplant recipients with PV replication and smoking are at particular risk to develop bladder carcinomas and support the need for long-term cancer surveillance in these patients.
Author Haririan, Abdolreza
Alexiev, Borislav A
Chaudhry, Muhammad R
Drachenberg, Cinthia B
Papadimitriou, John C
Liu, Sandy
Berrebi, Alexander A
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  organization: 1 Department of Pathology, University of Maryland School of Medicine, Baltimore, MD. 2 Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
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Snippet Solid organ transplant recipients are at increased risk for developing malignancies. Polyomaviruses (PV) have been historically associated with experimental...
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StartPage 1488
SubjectTerms Academic Medical Centers
Adult
Female
Humans
Immunocompromised Host
Immunosuppressive Agents - adverse effects
Incidence
Kidney Transplantation - adverse effects
Male
Maryland - epidemiology
Middle Aged
Opportunistic Infections - diagnosis
Opportunistic Infections - epidemiology
Opportunistic Infections - immunology
Opportunistic Infections - virology
Polyomavirus - growth & development
Polyomavirus - immunology
Polyomavirus Infections - diagnosis
Polyomavirus Infections - epidemiology
Polyomavirus Infections - immunology
Polyomavirus Infections - virology
Retrospective Studies
Risk Factors
Smoking - adverse effects
Time Factors
Treatment Outcome
Urinary Bladder Neoplasms - diagnosis
Urinary Bladder Neoplasms - epidemiology
Urinary Bladder Neoplasms - immunology
Urinary Bladder Neoplasms - virology
Virus Replication
Title Polyomavirus Replication and Smoking Are Independent Risk Factors for Bladder Cancer After Renal Transplantation
URI https://www.ncbi.nlm.nih.gov/pubmed/27232933
Volume 101
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