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Time Trends in Risk...
Time Trends in Risk and Risk Determinants of Non-Hodgkin Lymphoma in Solid Organ Transplant Recipients
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Fernberg, P. (author)
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- Edgren, G. (author)
- Karolinska Institutet
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Adami, J. (author)
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- Ingvar, Å. (author)
- Karolinska Institutet
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- Bellocco, R. (author)
- Karolinska Institutet
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- Tufveson, Gunnar (author)
- Uppsala universitet,Transplantationskirurgi
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- Höglund, P. (author)
- Karolinska Institutet
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- Kinch, Amelie (author)
- Uppsala universitet,Infektionssjukdomar
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- Simard, J. F. (author)
- Karolinska Institutet
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- Baecklund, Eva (author)
- Uppsala universitet,Reumatologi
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- Lindelöf, B. (author)
- Karolinska Institutet
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- Pawitan, Y. (author)
- Karolinska Institutet
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- Smedby, K. E. (author)
- Karolinska Institutet
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(creator_code:org_t)
- Elsevier BV, 2011
- 2011
- English.
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In: American Journal of Transplantation. - : Elsevier BV. - 1600-6135 .- 1600-6143. ; 11:11, s. 2472-2482
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Abstract
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- Organ transplantation increases risk of non-Hodgkin lymphoma (NHL), but long-term risk and time trends have seldom been evaluated. Immunosuppressive drug load is an important risk determinant, but the details are unclear. We studied NHL risk in a nationwide Swedish cohort of 11 081 graft recipients transplanted 1970-2008. Relative risks (RRs) were estimated within the cohort and versus the general population by age, sex, follow-up time and calendar period. NHL risk was also assessed by cumulative and average doses of immunosuppressive treatments in a nested case-control design throughout 1997 using conditional logistic regression. We observed 153 NHL cases during 97 853 years of follow-up. Compared with the general population, NHL risk was eightfold increased (RR 7.9; 95% confidence interval [CI] 6.6-9.4), and increased risks persisted after >= 15 years of follow-up among kidney (6.1; 95% CI 3.5-10) and nonkidney recipients (44; 14-103). Among nonkidney recipients, NHL risk was lower in the 2000s compared with the 1990s (0.5; 95% CI 0.3-1.0; p = 0.04). A high average dose of antithymocyte immunoglobulin (ATG) conferred an eightfold increased risk of NHL (OR 8.5; 95% CI 1.9-38). To conclude, posttransplant NHL risk decreased during the last decade among nonkidney recipients, possibly because of a more careful use of ATG, the introduction of new drugs, or both.
Keyword
- Antithymocyte immunoglobulin
- Epstein-Barr virus
- immunosuppression
- non-Hodgkin lymphoma
- organ transplantation
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Fernberg, P.
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Edgren, G.
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Adami, J.
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Ingvar, Å.
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Bellocco, R.
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Tufveson, Gunnar
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show more...
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Höglund, P.
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Kinch, Amelie
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Simard, J. F.
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Baecklund, Eva
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Lindelöf, B.
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Pawitan, Y.
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Smedby, K. E.
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show less...
- Articles in the publication
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American Journal ...
- By the university
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Uppsala University
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Karolinska Institutet