{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:27:23Z","timestamp":1781522843950,"version":"3.54.1"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T00:00:00Z","timestamp":1513555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Study Objective<\/jats:title>To evaluate the risk of posttransplantation malignancy in renal transplant recipients exposed to pretransplantation cyclophosphamide for the treatment of glomerular nephropathy (GN<\/jats:styled-content>).<\/jats:p><\/jats:sec>Design<\/jats:title>Retrospective cohort study.<\/jats:p><\/jats:sec>Setting<\/jats:title>Tertiary academic medical center.<\/jats:p><\/jats:sec>Patients<\/jats:title>Six hundred adult renal transplant recipients were transplanted between 1993 and 2014; 54 patients were exposed to pretransplantation cyclophosphamide for treatment of GN<\/jats:styled-content> (GN<\/jats:styled-content>\u2010CYC<\/jats:styled-content> group), and 546 patients with polycystic kidney disease were not exposed to pretransplantation cyclophosphamide (PKD<\/jats:styled-content> group).<\/jats:p><\/jats:sec>Measurement and Main Results<\/jats:title>Data were collected retrospectively from electronic medical records. The primary outcome was occurrence of posttransplantation malignancy. During a median follow\u2010up of 5.5 years, 130 patients developed malignancy (incidence rate 3.5 events per 100 person\u2010yrs). Exposure to cyclophosphamide before transplantation was significantly associated with malignancy after transplantation (adjusted hazard ratio [aHR<\/jats:styled-content>] 2.20, 95% confidence interval [CI<\/jats:styled-content>] 1.16\u20134.22, p=0.02), specifically skin cancer (aHR<\/jats:styled-content> 2.24, 95% CI<\/jats:styled-content> 1.09\u20134.60, p=0.03). Malignancy risk in the GN<\/jats:styled-content>\u2010CYC<\/jats:styled-content> group was higher in the setting of lymphocyte\u2010depleting induction (alemtuzumab; aHR<\/jats:styled-content> 4.53, 95% CI<\/jats:styled-content> 0.99\u201320.72, p=0.05) compared with basiliximab induction. Incidences of death\u2010censored graft loss and mortality were similar between the GN<\/jats:styled-content>\u2010CYC<\/jats:styled-content> and PKD<\/jats:styled-content> groups.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In our observational study, renal transplant recipients exposed to pretransplantation cyclophosphamide appeared to have a higher risk of developing a malignancy compared with unexposed renal transplant recipients. Further investigation into the impact of pretransplantation immunosuppression on malignancy, particularly the compounded effect with lymphocyte\u2010depleting induction, is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2059","type":"journal-article","created":{"date-parts":[[2017,11,14]],"date-time":"2017-11-14T11:37:34Z","timestamp":1510659454000},"page":"51-57","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Malignancy in Renal Transplant Recipients Exposed to Cyclophosphamide Prior to Transplantation for the Treatment of Native Glomerular Disease"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-9727","authenticated-orcid":false,"given":"Margaret R.","family":"Jorgenson","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics Madison Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-5110","authenticated-orcid":false,"given":"Jillian L.","family":"Descourouez","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics Madison Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tripti","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine University of Wisconsin\u2010Madison School of Medicine and Public Health Madison Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad C.","family":"Astor","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine University of Wisconsin\u2010Madison School of Medicine and Public Health Madison Wisconsin"},{"name":"Department of Population Health Sciences University of Wisconsin\u2010Madison School of Medicine and Public 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