Camos et?al.  showed that the incidence of AML following liver transplantation is higher than expected for the general population. selleck products Similarly, Offman et?al.  showed, in a large population study of more than 170?000 organ recipients, that organ transplantation was associated with an increased risk of AML. Specifically, the relative risk of AML in transplant recipients compared with controls matched for age, sex, and geographical origin was 5.5 for heart/lung and 2.1 for kidney recipients. 90% and 64% of heart/lung and kidney recipients, respectively, who developed PT-AML were males. The sex bias, as the authors mentioned, might have arisen from the predominance of males among transplant selleck recipients. In the largest multicentric study to date , reviewing data from more than 200?000 cases of renal and 30?000 cases of heart transplantation, the standardized incidence ratios for developing AML were 1.9 and 5.1, respectively (P?<?0.001 for both). Offman et?al.  noted that while there is an excess of AML (compared with the general population) in the first 3?C4?yr after transplantation, the incidence of PT-AML diverged sharply from the expected incidence thereafter. In a comparative analysis of patients with postrenal transplantation AML (n?=?16) and postliver transplantation AML (n?=?13), the median interval between transplantation and AML was significantly longer for the former patients (5.5 vs. 2?yr, respectively; P?=?0.03) . Twelve (3.4%) of the 348 patients in another large study of postrenal Rigosertib transplantation developed AML , with a latency interval of at least 11?months, and 100% disease-related mortality. In a large previous study, the increased risk of AML after heart transplantation did not begin until 3?C4?yr post-transplant, whereas the risk of AML after renal transplantation started to rise earlier and in a linear manner . The reported cases of PT-AML in our series increased in frequency from 1974 (first case) to 2000, when the incidence peaked, and then declined again until 2013 (Fig.?1). With the rarity of PT-AML and potential publication bias, it is hard to determine whether the apparent peak around year 2000 represents a true increase in incidence. Cases from North America (44%) and Europe (40%) comprised 84% of the entire data set (Fig.?1; n?=?50). Again, publication bias may explain this difference in incidence among continents. Table?1 shows a summary of our analysis. PT-AML occurred after transplantation of kidneys, liver, heart, and lungs in 23 (45%), 20 (39%), 6 (12%), and 2 (4%) cases, respectively. The nature of the present review does not allow for comparing different organ transplantation categories in terms of PT-AML incidence. The median age at diagnosis of AML was 50?yr, 5?yr older than a previous large report .
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