April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
De-novo Malignancies After Tacrolimus Therapy In The Management Of Ocular Inflammatory Diseases
Author Affiliations & Notes
  • Uday K. Bhatt
    Ophthalmology, Nottingham University Hospitals, Leicester, United Kingdom
  • Dev Raj
    Ophthalmology, Nottingham University Hospitals, Nottingham, United Kingdom
  • Harminder S. Dua
    Ophthalmology, Nottingham University Hospitals, Nottingham, United Kingdom
  • Footnotes
    Commercial Relationships  Uday K. Bhatt, None; Dev Raj, None; Harminder S. Dua, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6583. doi:
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      Uday K. Bhatt, Dev Raj, Harminder S. Dua; De-novo Malignancies After Tacrolimus Therapy In The Management Of Ocular Inflammatory Diseases. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6583.

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Abstract

Purpose: : To analyze the incidence and type of malignancies in patients receiving long term Tacrolimus as the immunosuppressive agent for various ocular conditions.

Methods: : Between Jan 1999 to Dec 2009, the case notes of all 212 patients who had received Tacrolimus for immunosuppression in the management of a variety of ocular conditions such as high risk corneal grafts, uveitis, corneal stem cell allograft and scleritis were reviewed. Tacrolimus treatment dosage, schedule and duration of treatment were noted.

Results: : There were 16 patients (7.54%) who developed ≥1 malignancy after mean (±SD) duration of 45±26 months after the start of treatment. The skin malignancies included squamous cell carcinomas (n=2), basal cell carcinoma (n=2), and melanoma (n=1). The number of patients diagnosed with non-dermatological malignancies were as follows- prostate (n=3), lymphoproliferative (n=2), lung (n=2), bowel (n=1), kidney (n=1), ovarian (n=1), and breast (n=1). Multivariate analysis showed that the duration of treatment as the common statistically significant (p<.005) factor for both skin and non-skin malignancies.

Conclusions: : The incidence of de-novo malignancy in patients treated with Tacrolimus is many times higher than in general population. It therefore demands careful long-term screening with high index of suspicion to facilitate the diagnosis and treatment in the early stages of a malignancy to improve patient survival.

Keywords: inflammation • immunomodulation/immunoregulation • tumors 
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