Voriconazole increases the risk for cutaneous squamous cell carcinoma after lung transplantation
| Autor: | Jenny Hu, Abbas Ardehali, Erin Lindsey Duffy, Vishad Nabili, Michael Y. Shino, Alice Zhang, David M. Sayah, B. Kubak, Rajan Saggar, Nicholas A. Kolaitis, S. Samuel Weigt, Rajeev Saggar, Joseph P. Lynch, David Torres Barba, David J. Ross, Michelle Lo, David Elashoff, Ariss Derhovanessian, Teresa Soriano, Meng Chen, John A. Belperio |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
Male medicine.medical_specialty Antifungal Agents Skin Neoplasms Time Factors medicine.medical_treatment Population 030230 surgery 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Lung transplantation Humans Risk factor education Aged Proportional Hazards Models Retrospective Studies Voriconazole education.field_of_study Transplantation Proportional hazards model business.industry Middle Aged medicine.disease stomatognathic diseases Immunology Chemoprophylaxis Carcinoma Squamous Cell Regression Analysis Female Skin cancer Risk assessment business medicine.drug Lung Transplantation |
| Zdroj: | Transplant international : official journal of the European Society for Organ Transplantation. 30(1) |
| ISSN: | 1432-2277 |
| Popis: | Lung transplant recipients (LTR) are at high risk of cutaneous squamous cell carcinoma (SCC). Voriconazole exposure after lung transplant has recently been reported as a risk factor for SCC. We sought to study the relationship between fungal prophylaxis with voriconazole and the risk of SCC in sequential cohorts from a single center. We evaluated 400 adult LTR at UCLA between 7/1/2005 and 12/22/2012. On 7/1/2009, our center instituted a protocol switch from targeted to universal antifungal prophylaxis for at least 6 months post-transplant. Using Cox proportional hazards models, time to SCC was compared between targeted (N = 199) and universal (N = 201) prophylaxis cohorts. Cox models were also used to assess SCC risk as a function of time-dependent cumulative exposure to voriconazole and other antifungal agents. The risk of SCC was greater in the universal prophylaxis cohort (HR 2.02, P < 0.01). Voriconazole exposure was greater in the universal prophylaxis cohort, and the cumulative exposure to voriconazole was associated with SCC (HR 1.75, P < 0.01), even after adjustment for other important SCC risk factors. Voriconazole did not increase the risk of advanced tumors. Exposure to other antifungal agents was not associated with SCC. Voriconazole should be used cautiously in this population. |
| Databáze: | OpenAIRE |
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