Chemotherapy and Transplantation: The Role of Immunosuppression in Malignancy and a Review of Antineoplastic Agents in Solid Organ Transplant Recipients

• Published in: American journal of transplantation Vol. 17; no. 8; pp. 1974 - 1991
• Main Authors: Krisl, J. C., Doan, V. P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01-08-2017
• Subjects: Antineoplastic Agents - therapeutic use; Antineoplastic drugs; Antitumor agents; Cancer; cancer/malignancy/neoplasia: chemotherapy; Chemotherapy; clinical research/practice; Health risk assessment; Humans; Immune Tolerance; immunosuppressant; Immunosuppression; Immunosuppression Therapy; immunosuppression/immune modulation; Immunosuppressive agents; Immunosurveillance; Lymphocytes; Malignancy; Neoplasms - drug therapy; Neoplasms - etiology; Organ Transplantation - adverse effects; pharmacology; Reviews; Risk factors; Side effects; Skin cancer; Transplant Recipients; Transplantation; Transplants & implants; immunosuppressant; cancer/malignancy/neoplasia: chemotherapy; immunosuppression/immune modulation; clinical research/practice; pharmacology
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/ajt.14238

It is estimated that solid organ transplant recipients have a two‐ to fourfold greater overall risk of malignancy than the general population. Some of the most common malignancies after transplant include skin cancers and posttransplant lymphoproliferative disorder. In addition to known risk factors such as environmental exposures, genetics, and infection with oncogenic viruses, immunosuppression plays a large role in the development of cancer through the loss of the immunosurveillance process. The purpose of this article is to explain the role of immunosuppression in cancer and to review the classes of chemotherapeutics. The field of anticancer drugs is continually expanding and developing, with limited data on use in transplant recipients. This article aims to provide information on class review, adverse effects, dose adjustments, and drug interactions that are pertinent to the care of transplant recipients.
The authors discuss the role of immunosuppression in malignancy posttransplant and review antineoplastic agents, including adverse effects, drug interactions, and important factors regarding their use in transplant recipients. See the editorial from Engels on page 1967.