Clinicopathological features, MCPyV status and outcomes of Merkel cell carcinoma in solid-organ transplant recipients: a retrospective, multicentre cohort study.
J Eur Acad Dermatol Venereol
; 36(11): 1991-2001, 2022 Nov.
Article
en En
| MEDLINE
| ID: mdl-35607918
ABSTRACT
BACKGROUND:
The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes.OBJECTIVE:
To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes.METHODS:
Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction.RESULTS:
A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR 4.3 [1.5-13], P = 0.008 and SHR 3.6 [1.1-12], P = 0.032 respectively) in SOTR.LIMITATIONS:
Retrospective design and heterogeneity of SOTR cohort.CONCLUSIONS:
MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
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Infecciones Tumorales por Virus
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Carcinoma de Células de Merkel
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Trasplante de Órganos
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Infecciones por Polyomavirus
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Poliomavirus de Células de Merkel
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Eur Acad Dermatol Venereol
Asunto de la revista:
DERMATOLOGIA
/
DOENCAS SEXUALMENTE TRANSMISSIVEIS
Año:
2022
Tipo del documento:
Article
País de afiliación:
España