Immunosuppression and lung cancer of donor origin after bilateral lung transplantation

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 76; no. 1; pp. 118 - 122
• Main Authors: von Boehmer, Lotta, Draenert, Alice, Jungraithmayr, Wolfgang, Inci, Ilhan, Niklaus, Schäfer, Boehler, Annette, Hofer, Markus, Stahel, Rolf, Soltermann, Alex, van den Broek, Maries, Weder, Walter, Knuth, Alexander
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ireland Ltd 01.04.2012; Elsevier
• Subjects: Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - etiology; Carcinoma, Non-Small-Cell Lung - pathology; Female; Hematology, Oncology and Palliative Medicine; Humans; Immunosuppression; Immunosurveillance; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - therapy; Lung Neoplasms - etiology; Lung Neoplasms - pathology; Lung transplantation; Lung Transplantation - adverse effects; Medical sciences; Middle Aged; Non-small cell lung cancer; Pneumology; Prognosis; Pulmonary Fibrosis - etiology; Pulmonary/Respiratory; Tissue Donors; Tumor infiltrating lymphocytes; Tumors; Tumors of the respiratory system and mediastinum; Immunosurveillance; Immunosuppression; Tumor infiltrating lymphocytes; Lung transplantation; Non-small cell lung cancer; Lung disease; Respiratory disease; Lung cancer; Lung; Bilateral; Transplantation; Malignant tumor; non-small cell lung carcinoma; Homotransplantation; Cancerology; Treatment; Donor; Surgery; Graft; Bronchus disease; Lymphocyte; Cancer; Pneumology
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2011.10.001

Abstract Analysis of databases from transplant recipients revealed a 3–5 fold higher risk to develop de novo malignancies under continued immunosuppression. The underlying mechanisms are poorly understood. Here we describe a patient who received a bilateral lung transplantation for end-stage ‘Usual Interstitial Pneumonia’ (UIP) resulting in idiopathic lung fibrosis. The recipient presented with a non-small cell lung carcinoma (NSCLC) in the donor lung 7 months later. Molecular and immunological typing of the tumor revealed a cancer of donor origin with a prominent intratumoral immune cell infiltrate without detectable effector function. This is a unique case of de novo outgrowth of a NSCLC of donor origin under continued immunosuppression, supporting the concept of tumor immunosurveillance in vivo.