Gliomas following organ transplantation: analysis of the contents of a tumor registry

Abstract

The author and others have described a series of patients in whom gliomas have developed following solid organ transplantation. Additionally, patients infected with human immunodeficiency virus reportedly have an increased incidence of gliomas. The author sought to examine the association between the immunosuppressive state in organ transplant recipients and the development of gliomas. Reported cases of tumor in the transplant population of the Israel Penn International Transplant Tumor Registry (IPITTR) were examined. These cases were compared with predicted cases in the 2001 American Cancer Society (ACS) estimates. Of the 7256 malignant tumors listed in the IPITTR database, 19 (0.3%) were primary brain tumors, including 14 gliomas. Tumors known to occur at an increased frequency in transplant recipients accounted for a 1.6- to 2.9-fold increased percentage of cases in the IPITTR compared with 2001 ACS estimates. Tumors not thought to occur with an increased frequency in this population, such as gastrointestinal malignancy and lung cancer, had ratios of 0.19 to 0.35. The corresponding ratio for primary brain tumors was 0.19. None of the six cases previously described by the author and his colleagues was reported to the IPITTR. Primary brain tumors, including gliomas, do not appear to be overrepresented in the IPITTR, indicating that they may not arise with increased frequency in transplant recipients. Nevertheless, one cannot exclude the possibility that neurooncologists may have underreported such cases to this voluntary tumor registry.