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April 25, 1977

Skin Cancer in Immunosuppressed Patients

JAMA. 1977;237(17):1857-1858. doi:10.1001/jama.1977.03270440047022

The development of malignant neoplasms in renal transplant recipients is a problem of considerable practical importance as well as biological interest. There is not, however, a simple, acrossthe-board increase in the incidence of all types of neoplasms, as would be expected if this was due solely to the suppression of host defense mechanisms against carcinomas. Skin cancers (39%) and lymphomas (27%) account for approximately two thirds of all cases recorded in the Denver Transplant Tumor Registry.1 One explanation that has been offered for the increased incidence of lymphomas is that chronic antigenic stimulation of the host lymphoreticular system by the grafted tissue, which bears "nonself" histocompatibility antigens, may lead to the emergence of a neoplastic clone of lymphoid cells.2 This would not account for the problem of cutaneous carcinomas. Here are other explanations for the increased incidence of neoplasms3-5: (1) immunosuppressive therapy impairs the "surveillance" function of