A common question has always been in our minds – cancer risk
after cyclophosphamide use in renal diseases?
Membranous GN has been the landmark GN where
cyclophosphamide has been tried. The regimen with alternating months of this
agent with steroids is still the standard of care treatment for Membranous
GN. Other therapies have come and stayed
or gone, such as CNIs, MMF and rituximab.
They have varied outcomes.
Cancer risk after use of cyclophosphamide recently waslooked at a single center in Europe in this CJASN manuscript. Over 250 patients were followed over 6 years
and 127 patients were treated with cyclophosphamide (CYP). Cancer risk was 3 fold higher in this cohort
compared to ones not treated with CYP.
Interesting findings:
1.
As one would think, bladder ca would be the
highest risk, it was only 2 of the 20 observed
2.
Hematologic malignancies were highest in this
cohort
3.
Could some of their cases be secondary
membranous and hence had cases of early malignancies?
4.
Table 3 has malignancies listed as Lung, CLL,
lymphoma, prostate Ca, colon, AML, bladder and CML
5.
Majority were men
6.
Varied cancers ( 5) of them had membranous GN
that was APLAR2 negative but no time correlations was noted
No comments:
Post a Comment