Skin Cancer after Organ Transplantation (Cancer Treatment and Research, Vol. 146)

About this book

Skin Cancer after Organ Transplantation presents the state-of-the-art knowledge of cutaneous malignancies following organ transplantation. The life promoting and life enhancing benefits of solid organ transplantation is a major medical advance, but at the cost of the life-long immunosuppression needed to prevent rejection of the donated organ. This induction and maintenance of impaired immunological surveillance is paralleled by a significant increase in the incidence of specific cancers, of which skin cancers are highest.

The book is divided into four sections, providing a basic overview on transplantation medicine, different immunosuppressive agents and their impact on the skin’s immune system, epidemiology and pathophysiology of skin cancer, applicable prophylaxis and therapeutic measures.

1. Transplant medicine: Addresses the immunological background of organ transplantation, immunosuppression and the impact on the cutaneous immunosurveillance. Different immunosuppressive drugs are presented and their interaction with mechanisms of the cutaneous immunosurveillance against skin cancer, are discussed.

2. Post-transplant skin malignancies: Explores the pathogenesis of transplant skin cancer, epidemiological patterns in different geographical regions, clinical and histological features, etiological factors and molecular events in skin cancer induction and progression, i.e., photocarcinogenesis and UV-induced immunosuppression, and oncogenic viruses like human papillomavirus and human herpesvirus, type 8.

3. Specific skin cancers: Focuses on specific skin cancers in organ transplant recipients, especially the most predominant types, like squamous cell carcinoma, its precursor actinic keratoses, and basal cell carcinoma, but also malignant melanoma, Kaposi’s sarcoma, cutaneous T-cell lymphoma and other, more rare skin malignancies.

4. Prophylaxis and therapies: Experts in the field recommend management strategies for preventing and treating transplant skin cancer, with an emphasis on a multidisciplinary approach. As scientists and clinicians strive together to develop effective chemopreventative agents in the face of this accelerated carcinogenesis, there is a real opportunity for advances in the treatment of transplant skin malignancies to translate into reduced skin cancer in the general population.

"Immunosuppression is an essential component of organ transplantation. Unfortunately, the risk of skin cancer is drastically increased in this setting. Distinguished investigators discuss the cause and therapeutic strategies involving the spectrum of cutaneous malignancies associated with immunosuppression." Steven T. Rosen, M.D., Series Editor

Written for: Oncologists, dermatologists, transplant surgeons, primary care physicians, researchers

Keywords:

• cutaneous malignancy
• epidemiology
• immunosuppression
• organ transplantation
• pathophyssiology
• prophylaxis

Table of contents

Historical Perspective (Past Present Future).- Immunology of organ transplantation and allograft rejection.- Posttransplant Malignancies.- Kidney Transplantation.- Heart/lung Transplantation .- Liver Transplantation.- Bone Marrow Transplantation.- Other Transplants.- Immunosuppression.- Introduction and general issues.- Calcineurin inhibitors.- MMF/MMS.- m-TOR Inhibitors.- Azathioprine.- Corticosteroids.- FTY and other new drugs.- Induction therapies.- Tolerance induction.- Skin Immune System.- Posttransplant Malignancies General Overview.- Influence of organ and pre-existing disease.- Epidemiology and Region specific features.- Europe.- USA/Canada.- Australia/Asia.- Etiological factors in cutaneous carcinogenesis.- Introduction.- Photocarcinogenesis - DNA damage.- UV-induced immunosuppression.- Mechanisms related to immunosuppressive therapies.- Oncogenic viruses.- HPV Epidemiology.- UV-HPV Interactions.- HHV 8.- Molecular pathogenesis of BCC and SCC.- Genetic basis of melanoma.- Specific Skin Cancers.- Non-melanoma Skin Cancer.- Actinic keratosis.- Squamous cell carcinoma.- Basal cell carcinoma.- Malignancies in genitoanal area.- Malignant Melanoma.- Rare Skin Cancers.- Kaposi’s sarcoma.- Merkel cell carcinoma.- Cutaneous lymphomas.- Prophylaxis and Therapy.- Prophylaxis and screening pre-transplantation.- Aftercare - the multi disc-approach.- Patient education.- Sunscreens and sun protection.- Dosage and choice/combination of immunosuppression.- Surgical interventions.- Specific management of field cancerisation.- Destructive management.- Systemic Chemoprevention.- Management of metastatic skin cancers in OTR.- Index.