Risk of hematological malignancies in solid organ transplant recipients: a meta-analysis
Runchen Wang1, Zhenyu Huo1, Fan Ge2, Yaokai Wen1, Hengrui Liang4, Yu Jiang1, Zixuan Su1, Weiyi Lin2, Wenhua Liang3, Jianxing He4.
1Nanshan School, Guangzhou Medical University, Guangzhou, People's Republic of China; 2The First Clinical College, Guangzhou Medical University, Guangzhou, People's Republic of China; 3Department of Thoracic oncology, The 1st Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China; 4Department of Thoracic Surgery, The 1st Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
Introduction: Patients underwent solid organ transplantation are considered to be associated with an increased risk of developing hematological malignancies. We performed a meta-analysis to determine whether there was an increased risk of hematological malignancies in solid organ transplant recipients.
Materials and Methods: PubMed, Web of Science, EMBASE, Medline were searched. Random-effects model meta-analyses were used to calculate standardized incidence ratios (SIRs) for solid organ transplant recipients versus the general population, stratified by types of hematological malignancies (leukemia, lymphoma, non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, and multiple myeloma). Subgroup analyses were performed based on transplant type of each study.
Results and Discussion: Based on data from 565,153 patients in 52 studies, in solid organ transplant recipients, we identified a 6-fold higher risk of hematological malignancies (SIR: 6,24 [95%Cl: 2.48 - 7.16, p<0.001]). Among them, a 2.47-fold risk of leukemia (SIR: 2.47 [95% CI :1.74 - 3.50, p<0.001]), a 3.01-fold risk of multiple myeloma (SIR: 3.01 [95% CI: 2.29 – 3.95, P<0.001]), a 9.13-fold SIR of lymphoma (SIR: 9.13 [95% CI: 7,12 – 11.70, P<0.001], a 11.41-fold risk of non-Hodgkin’s lymphoma (SIR: 11.41 [95%Cl: 9.74 - 13.36, p<0.001]), and a 4.50-fold risk of Hodgkin's lymphoma (SIR: 4.50 [95% CI: 3.33 – 6.08, P<0.001]), compared with the general population. In subgroup analyses, we found that heart and/or lung transplant recipients has the highest SIRs compared with kidney or liver transplant recipients (Table 1).
Conclusion: Our study demonstrated that solid transplant recipients showed a significantly greater risk of hematological malignancies, which varied among different transplantation types. Such association can provide guidance for clinicians in the detection of hematological malignancies among solid organ transplantation recipients.
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