Risk of Melanoma and Other Skin Cancers Increased For Organ Transplant Recipients: Study

New research suggests there may be an increased risk of melanoma and other deadly skin cancers following an organ transplant.

According to findings of a study published this month in the medical journal JAMA Dermatology, solid organ transplant recipients were more likely to develop melanoma, the deadliest form of skin cancer, as well as Merkel cell carcinoma, a rare and aggressive type of skin cancer

Researchers from various cancer centers from across the United States conducted the study, involving nearly 445,000 solid organ transplant recipients who underwent transplant in the US between 1987 and 2017. They used data from the national transplant registry and 32 cancer registries.

Overall, the researchers found melanoma and Merkel cell carcinomas were the most common type of skin cancer to occur in organ recipients after their operation. The risk was elevated for cancers associated with viruses.

Melanoma is the deadliest form of skin cancer because it often spreads to other areas of the body. If left untreated, it can lead to death.

Merkel cell carcinoma is also a deadly and aggressive type of skin cancer that typically develops from a single bump on sun-exposed skin, often progressing rapidly.

Researchers diagnosed 2,380 nonkeratinocyte skin cancers. The data indicated 847 cases of skin cancers, or about 40% of the cases, occurred on the head and neck. Skin cancers in this area are suggestive of long-term and repeated exposure to UV radiation from the sun.

Of the total cases, the large majority, 62%, were melanoma. Another 14% were Merkel cell carcinoma, 8% were Kaposi sarcoma, 7% were sebaceous carcinoma, and 5% were cutaneous lymphomas.

The data indicates the risks were most strongly elevated for cancers associated with viruses, including Kaposi sarcoma, Merkel cell carcinoma, and extra nodal natural killer/T-cell lymphoma. Risks were also significantly higher for sebaceous carcinoma, anaplastic large cell lymphoma, and diffuse large B-cell lymphoma.

Researchers found several characteristics that increases an organ transplant recipient’s risk of skin cancer. Those factors include older age at the time of transplant, increased UV radiation exposure, increased time since the transplant, and being male.

The data also indicated patients who were treated with mammalian target of rapamycin inhibitors had a reduced incidence of melanoma incidence. That treatment appears to have helped to reduce the risk, researchers suggested.

The findings of the study are important considering nonkeratinocyte skin cancers are a significant cause of death for immunosuppressed solid organ transplant recipients.

UV exposure, immunosuppressed health, and viruses are all linked with increased risk of cancer in solid organ transplant recipients.

Researchers suggest high-risk groups would benefit from increased surveillance of skin cancer and perhaps treatment with mammalian target of rapamycin inhibitors. Those may be beneficial for prevention of melanoma among patients in the transplant population.