Evidence map›Paper›PMID 37397376›Full record

ArticleFrontiers in oncology2023

Multicenter analysis of immunosuppressive medications on the risk of malignancy following adult solid organ transplantation.

Reid Shaw, Ali R Haque, Tyler Luu, Timothy E O'Connor, Adam Hamidi, Jack Fitzsimons, Bianca Varda, Danny Kwon, Cody Whitcomb, Alex Gregorowicz and 5 more

Open access · goldAbstract read
In one paragraph

Article in Frontiers in oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Reid ShawDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Ali R HaqueDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Tyler LuuDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Timothy E O'ConnorDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Adam HamidiDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Jack FitzsimonsDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Bianca VardaDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Danny KwonDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Cody WhitcombDepartment of Internal Medicine, Loyola University Medical Center, Maywood, United States.
Alex GregorowiczDepartment of Pharmacy, Hines Veterans Affairs Hospital, Hines, United States.
Gregory W RoloffSection of Hematology and Oncology, The University of Chicago, Chicago, United States.
Bradford C BemissDivision of Pulmonary and Critical Care Medicine, Loyola University Medical Center, Maywood, United States.
Eric R KallwitzDivision of Hepatology, Loyola University Medical Center, Maywood, United States.
Patrick A HagenDivision of Hematology and Oncology, Loyola University Medical Center, Maywood, United States.
Stephanie BergDepartment of Medical Oncology, Lank Center for Genitourinary (GU) Dana-Farber Cancer Institute (DFCI), Harvard Medical School, Boston, MA, United States.
Loyola University Medical Center · USEdward Hines, Jr. VA Hospital · USHarvard University · USUniversity of Chicago · US

Funding

BASIC RESEARCH TRAINING IN MEDICAL ONCOLOGYT32CA009566 · NCI · UNIVERSITY OF CHICAGO · PI OLUFUNMILAYO F. OLOPADE · 1987 to 2026
$10.5M
NCI NIH HHS T32 CA009566
6 · The paper itself

Abstract

Objective: This study aimed to assess the risk of maintenance immunosuppression on the post-transplant risk of malignancy across all solid organ transplant types. Methods: This is a retrospective cohort study from a multicenter hospital system in the United States. The electronic health record was queried from 2000 to 2021 for cases of solid organ transplant, immunosuppressive medications, and post-transplant malignancy. Results: A total of 5,591 patients, 6,142 transplanted organs, and 517 post-transplant malignancies were identified. Skin cancer was the most common type of malignancy at 52.8%, whereas liver cancer was the first malignancy to present at a median time of 351 days post-transplant. Heart and lung transplant recipients had the highest rate of malignancy, but this finding was not significant upon adjusting for immunosuppressive medications (heart HR 0.96, 95% CI 0.72 - 1.3, p = 0.88; lung HR 1.01, 95% CI 0.77 - 1.33, p = 0.94). Random forest variable importance calculations and time-dependent multivariate cox proportional hazard analysis identified an increased risk of cancer in patients receiving immunosuppressive therapy with sirolimus (HR 1.41, 95% CI 1.05 - 1.9, p = 0.04), azathioprine (HR 2.1, 95% CI 1.58 - 2.79, p < 0.001), and cyclosporine (HR 1.59, 95% CI 1.17 - 2.17, p = 0.007), while tacrolimus (HR 0.59, 95% CI 0.44 - 0.81, p < 0.001) was associated with low rates of post-transplant neoplasia. Conclusion: Our results show varying risks of immunosuppressive medications associated with the development of post-transplant malignancy, demonstrating the importance of cancer detection and surveillance strategies in solid organ transplant recipients.

Indexed as

cancerimmunosuppressionimmunosuppressive therapymachine learningmalignancysolid organ transplant

Identifiers

PMID37397376
PMCPMC10313202
OpenAlexW4380989853

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.