Mycophenolate Mofetil and the Incidence of Skin Cancer in Kidney Transplant Recipients
1Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom, 2Dermatology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom, 3Renal Unit, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
Meeting: 2020 American Transplant Congress
Abstract number: A-225
Keywords: Azathioprine, Immunosuppression, Kidney transplantation, Post-transplant malignancy
Session Name: Poster Session A: PTLD/Malignancies: All Topics
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Over the years there has been a shift in the use of anti-metabolites agents from azathioprine to mycophenolate mofetil (MMF) based immunosuppression., due to its better efficacy and less implication in the development of skin cancer compared to azathioprine. However, MMF is still potentially carcinogenic.
*Methods: Secondary data of 941 Kidney Transplant Recipients (KTRs) who received kidney transplantation, from 1st January1998 to 31st December 2018 was obtained. The incidence of skin cancer was determined in 429 KTRs immunosuppressed with MMF. Chi-square test of independence was used to determine the association between use of MMF based immunosuppression and the development of skin cancer, and also to determine the risk factors associated with types of skin cancers developed.
*Results: MMF was associated more with the development of Basal Cell Carcinoma (BCC) in both males and females 5(41.7%) Vs 5(50%) than Squamous Cell Carcinoma (SCC) 3(25%) Vs 2 (20%). Females had a higher incidence of skin cancer than males (10 (5.8%) Vs 12 (4.7%)) although this was not statistically significant (P=0.582). The BCC subtypes identified in females were nodular superficial and infiltrative BCCs, while males had mainly nodular BCCs. The SCC subtypes in females were moderately differentiated and well differentiated SCCs, while males had mainly moderately differentiated SCC.only one male (8.3%) developed post-transplant lymphoproliferative disorder (PTLD). Being Caucasian and ≥ 50 years of age at transplantation were significantly associated with development of skin cancer (PS=0.022 and P=0.005 respectively). Interestingly, recipients of Human Leucocyte Antigen incompatible transplants (HLAi) were not associated with development of skin cancer.
*Conclusions: We concluded that The BCC and SCC histological subtypes associated with use of MMF were not the aggressive forms and can be easily treated by surgical excision. KTRs on MMF based immunosuppression will benefit from regular skin assessments.
To cite this abstract in AMA style:Yusuf SJ, Bheemreddy H, Imtiaz A, Krishnan N. Mycophenolate Mofetil and the Incidence of Skin Cancer in Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/mycophenolate-mofetil-and-the-incidence-of-skin-cancer-in-kidney-transplant-recipients/. Accessed March 26, 2023.
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