Ampliado el plazo de presentación de abstract hasta el día 24 de Octubre

 

48. SEVERE IGG HYPOGAMMAGLOBULINEMIA EARLY AFTER HEART TRANSPLANTATION IS ASSOCIATED WITH METASTASIC CANCER.

Carbone J, Limay K, Sousa I, Navarro J, Fernández-Yáñez J, Zatarain E, Gil J, Rodríguez-Molina Jj, Sarmiento E.

HOSPITAL GENERAL UNIVERSITARIO GREGORIO MARAÑÓN. MADRID.           

 

Introducción: Severe IgG hypogammaglobulinemia is a risk factor of infection in solid organ transplantation according to single center, multicenter studies and meta-analysis. Malignancy is still a relevant barrier to long term survival after heart transplantation. Immune monitoring of basic components of the immune response could be a useful tool to identify the risk for development of malignancy.

 

Objetivos: We aimed to identify immunological biomarkers that could be associated with risk of malignancy.

 

Metodología: In a prospective follow-up 265 patients were evaluated in a single center study. Mean age was 66 years (women 13%, men 87%). During a long-term follow-up, 69 patients developed at least one new malignancy after heart transplantation. Mean time from transplantation to diagnosis of post transplant malignancy was 4,71 years. A total of 122 malignancies were diagnosed: epithelial (35,2%), mucose (24,6%), metastasic cancer (8,2%). Immunological biomarkers were evaluated at the time of inclusion in waiting list and at 7 and 30 days after heart tranplantation.

 

Resultados: One-week after transplantation lower B-cell percentages (<3%) and lower B-cell absolute counts (<74 cells/uL) were risk factors for development of malignancy. Seven days after-transplantation, patients with severe IgG hypogammaglobulinemia (IgG<477 mg/dL, p=0,019), absolute NK-cell counts (<73/uL, p=0,004) and absolute T CD3+ counts (<209/uL) were at higher risk of having metastasic cancer after diagnosis of malignancy during follow-up. Clinical risk factors of malignancy were age> 66 years; smoke; ischemia, chronic inflammatory conditions and infections. Low B-cell counts at 7 days (LB <74 cell/uL, OR 6.19, 95% CI 2,25-17,07, p<0,001) were significantly associated with malignancy risk after adjustment by clinical variables.

 

Conclusiones: A profile of distinct immunological abnormalities is associated with a high risk for developing malignancy after heart transplantation. Severe IgG hypogammaglobulinemia early after heart transplantation is associated with a higher prevalence of metastasic cancer long term after transplantation.

 

 

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