LAST month, we presented here the general picture of kidney transplantation based on the multicenter study conducted by Behzad Einollahi and colleagues as reported in the Journal of Cancer (June 2012). This week you will know, in more detail, which immunosuppressant drugs have been causing it and briefly how. The study noted that the risk of developing malignancy in organ transplants is three-four times greater than general population. Before 2000, patients received a two-drug maintenance regimen consisting of prednisone and cyclosporine or azathioprine (AZA); or, a triple therapy with cyclosporine, prednisone and AZA. Afterward, most patients received not just cyclosporine and prednisone but mycophenolate mofetil (MMF) as well. Today, immunosuppressive therapy is a three-drug therapy using cyclosporine/sirolimus, MMF/AZA and steroids. The Einollahi study noted that more than half of the patients (61.3 percent) received AZA when they developed cancer....
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