Cancer risk associated with cytomegalovirus infection among solid organ transplant recipients in the United States. Issue 22 (20th September 2022)

• Record Type: Journal Article
• Authors: Geris, Jennifer M.; Spector, Logan G.; Pfeiffer, Ruth M.; Limaye, Ajit P.; Yu, Kelly J.; Engels, Eric A.
• Is Part Of: Cancer. Volume 128:Issue 22(2022)
• Page Start: 3985
• Page End: 3994
• Publication Date: 2022-09-20
• Subjects: cytomegalovirus (CMV) -- leukemia -- lymphoma -- solid organ transplantation -- solid tumors; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.34462
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : Background: Cytomegalovirus (CMV) is among the most common viral infections after solid organ transplantation (SOT). Associations of CMV with cancer risk among SOT recipients have been incompletely evaluated. Methods: The authors used linked data from the US SOT registry and 32 cancer registries. Poisson regression was used to compare cancer incidence across CMV risk groups based on donor (D) and recipient (R) immunoglobulin G (IgG) serostatus: high risk (R‐negative/D‐positive), moderate risk (R‐positive), and low risk (R‐negative/D‐negative). Results: In total, 247, 318 SOT recipients were evaluated during 2000–2017 (R‐negative/D‐positive, 20.3%; R‐positive, 62.9%; R‐negative/D‐negative, 16.8%). CMV‐seropositive recipients were older, more racially/ethnically diverse, and had lower socioeconomic status than CMV‐seronegative recipients. Compared with R‐negative/D‐negative recipients, recipients in the R‐negative/D‐positive and R‐positive groups had a lower incidence of diffuse large B‐cell lymphoma (DLBCL; R‐negative/D‐positive: adjusted incidence rate ratio [aIRR], 0.74; 95% confidence interval [CI], 0.59–0.91; R‐positive: aIRR, 0.83; 95% CI, 0.69–1.00). CMV serostatus modified the association between Epstein–Barr virus (EBV) status and DLBCL ( p = .0006): DLBCL incidence was increased for EBV R‐negative/D‐positive recipients (aIRR, 3.46; 95% CI, 1.50–7.95) among CMV R‐negative/D‐negative recipients but not among the other CMV risk groups. Compared with recipients who were CMV R‐negative/D‐negative, those who were R‐negative/D‐positive had a lower incidence of small intestine cancer (aIRR, 0.23; 95% CI, 0.09–0.63), and R‐positive recipients had a higher incidence of lung cancer (aIRR, 1.24; 95% CI, 1.05–1.46). CMV status was not associated with risk for other cancers. Conclusions: CMV status was not associated with risk for most cancers among SOT recipients. The inverse association with DLBCL may reflect the protective effects of CMV prophylaxis or treatment with off‐target efficacy against EBV infection (the major cause of lymphoma in SOT recipients). Abstract : Cancer is a major adverse outcome of solid organ transplantation (SOT), and prior donor and recipient cytomegalovirus (CMV) infections are common; however, associations of CMV with cancer risk among SOT recipients have been incompletely evaluated. In this analysis of 247, 318 SOT recipients, an inverse association between risk of CMV infection and diffuse large B‐cell lymphoma was observed; however, CMV status was not associated with risk for most other cancers.