Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases
The purpose of this systematic review and meta-analysis was to compare the risk of non-melanoma skin cancer (NMSC) and melanoma development in renal transplant recipients who receive calcineurin inhibitors to that of patients treated with other immunosuppressive agents, and investigate the possible...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/6/430 |
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| author | Aleksandra Kulbat Karolina Richter Tomasz Stefura Marta Kołodziej-Rzepa Michał Kisielewski Tomasz Wojewoda Wojciech M. Wysocki |
| author_facet | Aleksandra Kulbat Karolina Richter Tomasz Stefura Marta Kołodziej-Rzepa Michał Kisielewski Tomasz Wojewoda Wojciech M. Wysocki |
| author_sort | Aleksandra Kulbat |
| collection | DOAJ |
| description | The purpose of this systematic review and meta-analysis was to compare the risk of non-melanoma skin cancer (NMSC) and melanoma development in renal transplant recipients who receive calcineurin inhibitors to that of patients treated with other immunosuppressive agents, and investigate the possible association between the type of maintenance immunosuppression and the incidence of NSMC and melanoma in this group of patients. The authors searched databases such as PubMed, Scopus, and Web of Science for articles that would help establish the influence of calcineurin inhibitors on skin cancer development. The inclusion criteria for the study consisted of randomized clinical trials, cohort studies, and case-control studies that compared patients who received kidney transplants and were treated with a calcineurin inhibitor (CNI), such as cyclosporine A (CsA) or tacrolimus (Tac), to those who received alternative immunosuppressants and did not receive a CNI. Seven articles were analyzed overall. The results revealed a correlation between CNI treatment in renal transplant recipients and increased total skin cancer risk (OR 1.28; 95% CI: 0.10–16.28; <i>p</i> < 0.01), melanoma risk (OR 1.09; 95% CI: 0.25–4.74; <i>p</i> < 0.01), and NMSC risk (OR 1.16; 95% CI: 0.41–3.26; <i>p</i> < 0.01). In conclusion, the calcineurin inhibitors used after kidney transplantation are associated with a higher risk of skin cancer—both non-melanoma and melanoma—when compared with other immunosuppressive therapies. This finding suggests that careful monitoring for skin lesions in post-transplant patients must be conducted. However, the decision on the kind of immunotherapy used should always be considered on an individual basis for each renal transplant recipient. |
| first_indexed | 2024-03-11T02:36:06Z |
| format | Article |
| id | doaj.art-bc664564b0bc4eacb13d88ecbce7d68c |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T02:36:06Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-bc664564b0bc4eacb13d88ecbce7d68c2023-11-18T09:58:04ZengMDPI AGCurrent Oncology1198-00521718-77292023-06-013065727573710.3390/curroncol30060430Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 CasesAleksandra Kulbat0Karolina Richter1Tomasz Stefura2Marta Kołodziej-Rzepa3Michał Kisielewski4Tomasz Wojewoda5Wojciech M. Wysocki6The Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandChair of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, 30-705 Kraków, PolandDepartment of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Kraków, PolandDepartment of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Kraków, PolandDepartment of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Kraków, PolandDepartment of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Kraków, 30-901 Kraków, PolandThe Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, PolandThe purpose of this systematic review and meta-analysis was to compare the risk of non-melanoma skin cancer (NMSC) and melanoma development in renal transplant recipients who receive calcineurin inhibitors to that of patients treated with other immunosuppressive agents, and investigate the possible association between the type of maintenance immunosuppression and the incidence of NSMC and melanoma in this group of patients. The authors searched databases such as PubMed, Scopus, and Web of Science for articles that would help establish the influence of calcineurin inhibitors on skin cancer development. The inclusion criteria for the study consisted of randomized clinical trials, cohort studies, and case-control studies that compared patients who received kidney transplants and were treated with a calcineurin inhibitor (CNI), such as cyclosporine A (CsA) or tacrolimus (Tac), to those who received alternative immunosuppressants and did not receive a CNI. Seven articles were analyzed overall. The results revealed a correlation between CNI treatment in renal transplant recipients and increased total skin cancer risk (OR 1.28; 95% CI: 0.10–16.28; <i>p</i> < 0.01), melanoma risk (OR 1.09; 95% CI: 0.25–4.74; <i>p</i> < 0.01), and NMSC risk (OR 1.16; 95% CI: 0.41–3.26; <i>p</i> < 0.01). In conclusion, the calcineurin inhibitors used after kidney transplantation are associated with a higher risk of skin cancer—both non-melanoma and melanoma—when compared with other immunosuppressive therapies. This finding suggests that careful monitoring for skin lesions in post-transplant patients must be conducted. However, the decision on the kind of immunotherapy used should always be considered on an individual basis for each renal transplant recipient.https://www.mdpi.com/1718-7729/30/6/430calcineurin inhibitorscyclosporinetacrolimusskin cancermelanoma skin cancernon-melanoma skin cancer |
| spellingShingle | Aleksandra Kulbat Karolina Richter Tomasz Stefura Marta Kołodziej-Rzepa Michał Kisielewski Tomasz Wojewoda Wojciech M. Wysocki Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases Current Oncology calcineurin inhibitors cyclosporine tacrolimus skin cancer melanoma skin cancer non-melanoma skin cancer |
| title | Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases |
| title_full | Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases |
| title_fullStr | Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases |
| title_full_unstemmed | Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases |
| title_short | Systematic Review of Calcineurin Inhibitors and Incidence of Skin Malignancies after Kidney Transplantation in Adult Patients: A Study of 309,551 Cases |
| title_sort | systematic review of calcineurin inhibitors and incidence of skin malignancies after kidney transplantation in adult patients a study of 309 551 cases |
| topic | calcineurin inhibitors cyclosporine tacrolimus skin cancer melanoma skin cancer non-melanoma skin cancer |
| url | https://www.mdpi.com/1718-7729/30/6/430 |
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