Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression

Y. J. Wang, N. H. Chi, N. K. Chou, S. C. Huang, C. H. Wang, I. H. Wu, H. Y. Yu, Y. S. Chen, C. I. Tsao, C. T. Shun, J. T. Tsai, S. S. Wang

研究成果: 雜誌貢獻文章

5 引文 (Scopus)

摘要

Background With advances in immunosuppressive therapy, heart transplantation is currently recommended as the only established surgical treatment for refractory heart failure. However, chronic immunosuppression increases the risk for malignancy. Everolimus (EVR) is a potent mammalian target of rapamycin inhibitor that is used after transplantation and to treat advanced malignancies, as we have done in Taiwan after heart transplantation since 2004. Mycophenolate mofetil (MMF) and EVR are frequently used as cell-cycle inhibitors to optimize post-transplantation outcomes. Methods We retrospectively analyzed the characteristics and outcomes of 454 patients who received either MMF (n = 232) or EVR (n = 222) after heart transplantation at the National Taiwan University Hospital from March 1, 1990, to March 1, 2015. Patient characteristics and Kaplan-Meier survival curves were compared between groups. Results During a median follow-up of 69.2 months, malignancy was diagnosed in 27 patients receiving MMF (n = 23) or EVR (n = 4). There was a significant difference in malignancy risk between groups (9.91% vs 1.80%, P =.001). The most common malignancies were non-Hodgkin lymphoma, skin cancers, and lung squamous cell carcinoma. The 2-year overall survival after malignancy was 50% in the EVR group and 47% in the MMF group (P =.745). Conclusions EVR treatment after heart transplant is associated with a lower risk of malignancy than is MMF treatment. The 2-year survival rate after malignancy was similar between EVR and MMF groups.

原文英語
頁(從 - 到)969-973
頁數5
期刊Transplantation Proceedings
48
發行號3
DOIs
出版狀態已發佈 - 四月 1 2016

指紋

Mycophenolic Acid
Heart Transplantation
Immunosuppression
Neoplasms
Taiwan
Transplantation
Everolimus
Kaplan-Meier Estimate
Skin Neoplasms
Sirolimus
Therapeutics
Immunosuppressive Agents
Non-Hodgkin's Lymphoma
Squamous Cell Carcinoma
Lung Neoplasms
Cell Cycle
Survival Rate
Heart Failure
Transplants
Survival

ASJC Scopus subject areas

  • Surgery
  • Transplantation

引用此文

Wang, Y. J., Chi, N. H., Chou, N. K., Huang, S. C., Wang, C. H., Wu, I. H., ... Wang, S. S. (2016). Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression. Transplantation Proceedings, 48(3), 969-973. https://doi.org/10.1016/j.transproceed.2015.12.071

Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression. / Wang, Y. J.; Chi, N. H.; Chou, N. K.; Huang, S. C.; Wang, C. H.; Wu, I. H.; Yu, H. Y.; Chen, Y. S.; Tsao, C. I.; Shun, C. T.; Tsai, J. T.; Wang, S. S.

於: Transplantation Proceedings, 卷 48, 編號 3, 01.04.2016, p. 969-973.

研究成果: 雜誌貢獻文章

Wang, YJ, Chi, NH, Chou, NK, Huang, SC, Wang, CH, Wu, IH, Yu, HY, Chen, YS, Tsao, CI, Shun, CT, Tsai, JT & Wang, SS 2016, 'Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression', Transplantation Proceedings, 卷 48, 編號 3, 頁 969-973. https://doi.org/10.1016/j.transproceed.2015.12.071
Wang, Y. J. ; Chi, N. H. ; Chou, N. K. ; Huang, S. C. ; Wang, C. H. ; Wu, I. H. ; Yu, H. Y. ; Chen, Y. S. ; Tsao, C. I. ; Shun, C. T. ; Tsai, J. T. ; Wang, S. S. / Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression. 於: Transplantation Proceedings. 2016 ; 卷 48, 編號 3. 頁 969-973.
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title = "Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression",
abstract = "Background With advances in immunosuppressive therapy, heart transplantation is currently recommended as the only established surgical treatment for refractory heart failure. However, chronic immunosuppression increases the risk for malignancy. Everolimus (EVR) is a potent mammalian target of rapamycin inhibitor that is used after transplantation and to treat advanced malignancies, as we have done in Taiwan after heart transplantation since 2004. Mycophenolate mofetil (MMF) and EVR are frequently used as cell-cycle inhibitors to optimize post-transplantation outcomes. Methods We retrospectively analyzed the characteristics and outcomes of 454 patients who received either MMF (n = 232) or EVR (n = 222) after heart transplantation at the National Taiwan University Hospital from March 1, 1990, to March 1, 2015. Patient characteristics and Kaplan-Meier survival curves were compared between groups. Results During a median follow-up of 69.2 months, malignancy was diagnosed in 27 patients receiving MMF (n = 23) or EVR (n = 4). There was a significant difference in malignancy risk between groups (9.91{\%} vs 1.80{\%}, P =.001). The most common malignancies were non-Hodgkin lymphoma, skin cancers, and lung squamous cell carcinoma. The 2-year overall survival after malignancy was 50{\%} in the EVR group and 47{\%} in the MMF group (P =.745). Conclusions EVR treatment after heart transplant is associated with a lower risk of malignancy than is MMF treatment. The 2-year survival rate after malignancy was similar between EVR and MMF groups.",
author = "Wang, {Y. J.} and Chi, {N. H.} and Chou, {N. K.} and Huang, {S. C.} and Wang, {C. H.} and Wu, {I. H.} and Yu, {H. Y.} and Chen, {Y. S.} and Tsao, {C. I.} and Shun, {C. T.} and Tsai, {J. T.} and Wang, {S. S.}",
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T1 - Malignancy after Heart Transplantation under Everolimus Versus Mycophenolate Mofetil Immunosuppression

AU - Wang, Y. J.

AU - Chi, N. H.

AU - Chou, N. K.

AU - Huang, S. C.

AU - Wang, C. H.

AU - Wu, I. H.

AU - Yu, H. Y.

AU - Chen, Y. S.

AU - Tsao, C. I.

AU - Shun, C. T.

AU - Tsai, J. T.

AU - Wang, S. S.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background With advances in immunosuppressive therapy, heart transplantation is currently recommended as the only established surgical treatment for refractory heart failure. However, chronic immunosuppression increases the risk for malignancy. Everolimus (EVR) is a potent mammalian target of rapamycin inhibitor that is used after transplantation and to treat advanced malignancies, as we have done in Taiwan after heart transplantation since 2004. Mycophenolate mofetil (MMF) and EVR are frequently used as cell-cycle inhibitors to optimize post-transplantation outcomes. Methods We retrospectively analyzed the characteristics and outcomes of 454 patients who received either MMF (n = 232) or EVR (n = 222) after heart transplantation at the National Taiwan University Hospital from March 1, 1990, to March 1, 2015. Patient characteristics and Kaplan-Meier survival curves were compared between groups. Results During a median follow-up of 69.2 months, malignancy was diagnosed in 27 patients receiving MMF (n = 23) or EVR (n = 4). There was a significant difference in malignancy risk between groups (9.91% vs 1.80%, P =.001). The most common malignancies were non-Hodgkin lymphoma, skin cancers, and lung squamous cell carcinoma. The 2-year overall survival after malignancy was 50% in the EVR group and 47% in the MMF group (P =.745). Conclusions EVR treatment after heart transplant is associated with a lower risk of malignancy than is MMF treatment. The 2-year survival rate after malignancy was similar between EVR and MMF groups.

AB - Background With advances in immunosuppressive therapy, heart transplantation is currently recommended as the only established surgical treatment for refractory heart failure. However, chronic immunosuppression increases the risk for malignancy. Everolimus (EVR) is a potent mammalian target of rapamycin inhibitor that is used after transplantation and to treat advanced malignancies, as we have done in Taiwan after heart transplantation since 2004. Mycophenolate mofetil (MMF) and EVR are frequently used as cell-cycle inhibitors to optimize post-transplantation outcomes. Methods We retrospectively analyzed the characteristics and outcomes of 454 patients who received either MMF (n = 232) or EVR (n = 222) after heart transplantation at the National Taiwan University Hospital from March 1, 1990, to March 1, 2015. Patient characteristics and Kaplan-Meier survival curves were compared between groups. Results During a median follow-up of 69.2 months, malignancy was diagnosed in 27 patients receiving MMF (n = 23) or EVR (n = 4). There was a significant difference in malignancy risk between groups (9.91% vs 1.80%, P =.001). The most common malignancies were non-Hodgkin lymphoma, skin cancers, and lung squamous cell carcinoma. The 2-year overall survival after malignancy was 50% in the EVR group and 47% in the MMF group (P =.745). Conclusions EVR treatment after heart transplant is associated with a lower risk of malignancy than is MMF treatment. The 2-year survival rate after malignancy was similar between EVR and MMF groups.

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