Cancer risk associated with cytomegalovirus infection among solid organ transplant recipients in the United States
- 20 September 2022
- Vol. 128 (22), 3985-3994
- https://doi.org/10.1002/cncr.34462
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).Keywords
Funding Information
- National Institute of Allergy and Infectious Diseases (NIAID U0AI163090, U0AI163090)
- National Cancer Institute
- National Institutes of Health (T32 AI083196)
- University of Minnesota
- Fred Hutchinson Cancer Research Center (NU58DP006339‐05‐00)
- Centers for Disease Control and Prevention (NU58DP006320, 5U58DP000824‐04, NU58DP006288, NU58DP006284, NU58DP006317‐05‐01, U58DP003933, 6NU58DP006309, HHSN26100001, HHSN261201800014I, 5NU58DP006279‐02‐00, 5U58DP003921‐03, 5U58DP003883‐03, 1NU58DP006270, 5U58DP003875‐01, DP000848‐04, DP000807‐01, U58)
- Health Resources and Services Administration
- National Cancer Institute (HHSN261201800016I, N01‐PC‐35142, HHSN261201800013I, HHSN261201800012I, N01‐PC‐35143, HSN261201000032C, HHSN261201800006I, N01‐PC‐35139, N01‐PC‐35137, HHSN261201000037C, HHSN261201800002I, HHSN261201000034C, HHSN261201000035C, HHSN261201000036C)
- Health Resources and Services Administration
This publication has 34 references indexed in Scilit:
- Spectrum of Cancer Risk Among US Solid Organ Transplant RecipientsJAMA, 2011
- Human cytomegalovirus immunity and immune evasionVirus Research, 2011
- Detection of human cytomegalovirus in normal and neoplastic breast epitheliumHerpesviridae, 2010
- InterLymph hierarchical classification of lymphoid neoplasms for epidemiologic research based on the WHO classification (2008): update and future directionsBlood, 2010
- Cytomegalovirus-Induced γδ T Cells Associate with Reduced Cancer Risk after Kidney TransplantationJournal of the American Society of Nephrology, 2010
- Epidemiology of Pretransplant EBV and CMV Serostatus in Relation to Posttransplant Non-Hodgkin LymphomaTransplantation, 2009
- Socioeconomic disparities in the seroprevalence of cytomegalovirus infection in the US population: NHANES IIIEpidemiology and Infection, 2008
- Donor and recipient CMV serostatus and antigenemia after renal transplantation: An analysis of 486 patientsJournal of Clinical Virology, 2008
- Who is at risk for post-transplant lymphoproliferative disorders (PTLD) after liver transplantation?Journal of Hepatology, 2006
- Human γδ T cells: a nonredundant system in the immune-surveillance against cancerTrends in Immunology, 2002