Cytomegalovirus and cancer after kidney transplantation: Role of the human leukocyte antigen system?

Germaine Wong, Aron Chakera, Jeremy R. Chapman, Steve C. Chadban, Helen Pilmore, Jonathan C. Craig, Wai H. Lim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The role of cytomegalovirus (CMV) in cancer development after transplantation remains uncertain. We aimed to determine the association between donor and recipient CMV serological status and the risk of cancer development after kidney transplantation. Methods: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, we assessed the association between CMV donor/recipient (D/R) serological status and the risk of solid organ cancers in primary adult deceased-donor kidney transplant patients between 1990 and 2012. Results: Of 8140 recipients, a total of 895 (11%) recipients developed incident cancers during a follow-up time of 51 555 person-years. Human leukocyte antigen (HLA) mismatches was an effect modifier between CMV serological status and cancer (P=.03 for interaction). In recipients who have received 0-2 HLA-ABDR mismatched kidneys, the adjusted hazard ratios for cancer incidence among those with CMV D−/R−, CMV D−/R+, and CMV D+/R− were 0.47 (95% confidence interval [CI]: 0.24-0.91), 1.42 (95% CI: 0.97-2.07), and 1.02 (95% CI: 0.67-1.57), respectively compared with the reference of CMV D+/R+. A similar association was not observed in those with >2 HLA-ABDR mismatches. Conclusion: CMV D−/R− status was associated with a reduced risk of cancer in kidney transplant recipients who have received well-matched renal allografts, suggesting a potential role of HLA matching in cancer development.

Original languageEnglish
Article numbere12631
Pages (from-to)1-7
Number of pages7
JournalTransplant Infectious Disease
Volume19
Issue number1
DOIs
Publication statusPublished - 1 Feb 2017

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Kidney Neoplasms
HLA Antigens
Cytomegalovirus
Kidney Transplantation
Tissue Donors
Neoplasms
Confidence Intervals
Kidney
Transplants
New Zealand
Allografts
Registries
Dialysis
Transplantation
Incidence

Cite this

Wong, Germaine ; Chakera, Aron ; Chapman, Jeremy R. ; Chadban, Steve C. ; Pilmore, Helen ; Craig, Jonathan C. ; Lim, Wai H. / Cytomegalovirus and cancer after kidney transplantation : Role of the human leukocyte antigen system?. In: Transplant Infectious Disease. 2017 ; Vol. 19, No. 1. pp. 1-7.
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abstract = "Background: The role of cytomegalovirus (CMV) in cancer development after transplantation remains uncertain. We aimed to determine the association between donor and recipient CMV serological status and the risk of cancer development after kidney transplantation. Methods: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, we assessed the association between CMV donor/recipient (D/R) serological status and the risk of solid organ cancers in primary adult deceased-donor kidney transplant patients between 1990 and 2012. Results: Of 8140 recipients, a total of 895 (11{\%}) recipients developed incident cancers during a follow-up time of 51 555 person-years. Human leukocyte antigen (HLA) mismatches was an effect modifier between CMV serological status and cancer (P=.03 for interaction). In recipients who have received 0-2 HLA-ABDR mismatched kidneys, the adjusted hazard ratios for cancer incidence among those with CMV D−/R−, CMV D−/R+, and CMV D+/R− were 0.47 (95{\%} confidence interval [CI]: 0.24-0.91), 1.42 (95{\%} CI: 0.97-2.07), and 1.02 (95{\%} CI: 0.67-1.57), respectively compared with the reference of CMV D+/R+. A similar association was not observed in those with >2 HLA-ABDR mismatches. Conclusion: CMV D−/R− status was associated with a reduced risk of cancer in kidney transplant recipients who have received well-matched renal allografts, suggesting a potential role of HLA matching in cancer development.",
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Cytomegalovirus and cancer after kidney transplantation : Role of the human leukocyte antigen system? / Wong, Germaine; Chakera, Aron; Chapman, Jeremy R.; Chadban, Steve C.; Pilmore, Helen; Craig, Jonathan C.; Lim, Wai H.

In: Transplant Infectious Disease, Vol. 19, No. 1, e12631, 01.02.2017, p. 1-7.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cytomegalovirus and cancer after kidney transplantation

T2 - Role of the human leukocyte antigen system?

AU - Wong, Germaine

AU - Chakera, Aron

AU - Chapman, Jeremy R.

AU - Chadban, Steve C.

AU - Pilmore, Helen

AU - Craig, Jonathan C.

AU - Lim, Wai H.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: The role of cytomegalovirus (CMV) in cancer development after transplantation remains uncertain. We aimed to determine the association between donor and recipient CMV serological status and the risk of cancer development after kidney transplantation. Methods: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, we assessed the association between CMV donor/recipient (D/R) serological status and the risk of solid organ cancers in primary adult deceased-donor kidney transplant patients between 1990 and 2012. Results: Of 8140 recipients, a total of 895 (11%) recipients developed incident cancers during a follow-up time of 51 555 person-years. Human leukocyte antigen (HLA) mismatches was an effect modifier between CMV serological status and cancer (P=.03 for interaction). In recipients who have received 0-2 HLA-ABDR mismatched kidneys, the adjusted hazard ratios for cancer incidence among those with CMV D−/R−, CMV D−/R+, and CMV D+/R− were 0.47 (95% confidence interval [CI]: 0.24-0.91), 1.42 (95% CI: 0.97-2.07), and 1.02 (95% CI: 0.67-1.57), respectively compared with the reference of CMV D+/R+. A similar association was not observed in those with >2 HLA-ABDR mismatches. Conclusion: CMV D−/R− status was associated with a reduced risk of cancer in kidney transplant recipients who have received well-matched renal allografts, suggesting a potential role of HLA matching in cancer development.

AB - Background: The role of cytomegalovirus (CMV) in cancer development after transplantation remains uncertain. We aimed to determine the association between donor and recipient CMV serological status and the risk of cancer development after kidney transplantation. Methods: Using data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, we assessed the association between CMV donor/recipient (D/R) serological status and the risk of solid organ cancers in primary adult deceased-donor kidney transplant patients between 1990 and 2012. Results: Of 8140 recipients, a total of 895 (11%) recipients developed incident cancers during a follow-up time of 51 555 person-years. Human leukocyte antigen (HLA) mismatches was an effect modifier between CMV serological status and cancer (P=.03 for interaction). In recipients who have received 0-2 HLA-ABDR mismatched kidneys, the adjusted hazard ratios for cancer incidence among those with CMV D−/R−, CMV D−/R+, and CMV D+/R− were 0.47 (95% confidence interval [CI]: 0.24-0.91), 1.42 (95% CI: 0.97-2.07), and 1.02 (95% CI: 0.67-1.57), respectively compared with the reference of CMV D+/R+. A similar association was not observed in those with >2 HLA-ABDR mismatches. Conclusion: CMV D−/R− status was associated with a reduced risk of cancer in kidney transplant recipients who have received well-matched renal allografts, suggesting a potential role of HLA matching in cancer development.

KW - cancer

KW - cytomegalovirus

KW - epidemiology

KW - HLA

KW - kidney transplantation

KW - outcomes

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U2 - 10.1111/tid.12631

DO - 10.1111/tid.12631

M3 - Article

VL - 19

SP - 1

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JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

SN - 1398-2273

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