Time trends in risk and risk determinants of non-Hodgkin lymphoma in solid organ transplant recipients
(2011) In American Journal of Transplantation 11(11). p.82-2472- Abstract
Organ transplantation increases risk of non-Hodgkin lymphoma (NHL), but long-term risk and time trends have seldom been evaluated. Immunosuppressive drug load is an important risk determinant, but the details are unclear. We studied NHL risk in a nationwide Swedish cohort of 11 081 graft recipients transplanted 1970-2008. Relative risks (RRs) were estimated within the cohort and versus the general population by age, sex, follow-up time and calendar period. NHL risk was also assessed by cumulative and average doses of immunosuppressive treatments in a nested case-control design throughout 1997 using conditional logistic regression. We observed 153 NHL cases during 97 853 years of follow-up. Compared with the general population, NHL risk... (More)
Organ transplantation increases risk of non-Hodgkin lymphoma (NHL), but long-term risk and time trends have seldom been evaluated. Immunosuppressive drug load is an important risk determinant, but the details are unclear. We studied NHL risk in a nationwide Swedish cohort of 11 081 graft recipients transplanted 1970-2008. Relative risks (RRs) were estimated within the cohort and versus the general population by age, sex, follow-up time and calendar period. NHL risk was also assessed by cumulative and average doses of immunosuppressive treatments in a nested case-control design throughout 1997 using conditional logistic regression. We observed 153 NHL cases during 97 853 years of follow-up. Compared with the general population, NHL risk was eightfold increased (RR 7.9; 95% confidence interval [CI] 6.6-9.4), and increased risks persisted after ≥15 years of follow-up among kidney (6.1; 95% CI 3.5-10) and nonkidney recipients (44; 14-103). Among nonkidney recipients, NHL risk was lower in the 2000s compared with the 1990s (0.5; 95% CI 0.3-1.0; p = 0.04). A high average dose of antithymocyte immunoglobulin (ATG) conferred an eightfold increased risk of NHL (OR 8.5; 95% CI 1.9-38). To conclude, posttransplant NHL risk decreased during the last decade among nonkidney recipients, possibly because of a more careful use of ATG, the introduction of new drugs, or both.
(Less)
- author
- publishing date
- 2011-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adolescent, Adult, Aged, Antilymphocyte Serum/adverse effects, Case-Control Studies, Cohort Studies, Female, Follow-Up Studies, Humans, Immunosuppressive Agents/therapeutic use, Kidney Transplantation/adverse effects, Lymphoma, Non-Hodgkin/epidemiology, Male, Middle Aged, Risk, Sweden/epidemiology, T-Lymphocytes/immunology, Transplants/adverse effects
- in
- American Journal of Transplantation
- volume
- 11
- issue
- 11
- pages
- 11 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:82555202505
- pmid:21883909
- ISSN
- 1600-6135
- DOI
- 10.1111/j.1600-6143.2011.03704.x
- language
- English
- LU publication?
- no
- additional info
- ©2011 The Authors Journal compilation © 2011 The American Society of Transplantation and the American Society of Transplant Surgeons.
- id
- 22652dd5-b3d0-4abf-abf1-68d075d658a0
- date added to LUP
- 2020-11-16 10:03:19
- date last changed
- 2024-05-29 03:28:59
@article{22652dd5-b3d0-4abf-abf1-68d075d658a0, abstract = {{<p>Organ transplantation increases risk of non-Hodgkin lymphoma (NHL), but long-term risk and time trends have seldom been evaluated. Immunosuppressive drug load is an important risk determinant, but the details are unclear. We studied NHL risk in a nationwide Swedish cohort of 11 081 graft recipients transplanted 1970-2008. Relative risks (RRs) were estimated within the cohort and versus the general population by age, sex, follow-up time and calendar period. NHL risk was also assessed by cumulative and average doses of immunosuppressive treatments in a nested case-control design throughout 1997 using conditional logistic regression. We observed 153 NHL cases during 97 853 years of follow-up. Compared with the general population, NHL risk was eightfold increased (RR 7.9; 95% confidence interval [CI] 6.6-9.4), and increased risks persisted after ≥15 years of follow-up among kidney (6.1; 95% CI 3.5-10) and nonkidney recipients (44; 14-103). Among nonkidney recipients, NHL risk was lower in the 2000s compared with the 1990s (0.5; 95% CI 0.3-1.0; p = 0.04). A high average dose of antithymocyte immunoglobulin (ATG) conferred an eightfold increased risk of NHL (OR 8.5; 95% CI 1.9-38). To conclude, posttransplant NHL risk decreased during the last decade among nonkidney recipients, possibly because of a more careful use of ATG, the introduction of new drugs, or both.</p>}}, author = {{Fernberg, P and Edgren, G and Adami, J and Ingvar, A and Bellocco, R and Tufveson, G and Höglund, P and Kinch, A and Simard, J F and Baecklund, E and Lindelöf, B and Pawitan, Y and Smedby, K E}}, issn = {{1600-6135}}, keywords = {{Adolescent; Adult; Aged; Antilymphocyte Serum/adverse effects; Case-Control Studies; Cohort Studies; Female; Follow-Up Studies; Humans; Immunosuppressive Agents/therapeutic use; Kidney Transplantation/adverse effects; Lymphoma, Non-Hodgkin/epidemiology; Male; Middle Aged; Risk; Sweden/epidemiology; T-Lymphocytes/immunology; Transplants/adverse effects}}, language = {{eng}}, number = {{11}}, pages = {{82--2472}}, publisher = {{Wiley-Blackwell}}, series = {{American Journal of Transplantation}}, title = {{Time trends in risk and risk determinants of non-Hodgkin lymphoma in solid organ transplant recipients}}, url = {{http://dx.doi.org/10.1111/j.1600-6143.2011.03704.x}}, doi = {{10.1111/j.1600-6143.2011.03704.x}}, volume = {{11}}, year = {{2011}}, }