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