Document Detail


Regression of advanced melanoma upon withdrawal of immunosuppression: case series and literature review.
MedLine Citation:
PMID:  19890737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report two cases of stage IV malignant melanoma arising in patients treated with azathioprine for myasthenia gravis. In both cases, the melanoma metastases regressed upon withdrawal of immunosuppression. One patient remains melanoma free at 10 years, and the second patient experienced an 18-month disease free period. There is one prior case report in the medical literature to support full immune reconstitution for treatment in advanced immunosuppression-related melanoma, and one case series suggesting that transplant patients developing melanoma may benefit from a switch to sirolimus. Virtually, no data exist for the medical management of early stage melanoma in the immunosuppressed patients. We review the limited preclinical data in support of immune reconstitution and the data on immunosuppression as a risk factor for melanoma. We conclude that reduction or withdrawal of immunosuppression may be beneficial in patients with advanced stage melanoma and warrants further consideration in patients with early stage melanoma.
Authors:
P Dillon; N Thomas; N Sharpless; F Collichio
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-11-05
Journal Detail:
Title:  Medical oncology (Northwood, London, England)     Volume:  27     ISSN:  1559-131X     ISO Abbreviation:  Med. Oncol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-04-08     Revised Date:  2013-07-31    
Medline Journal Info:
Nlm Unique ID:  9435512     Medline TA:  Med Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1127-32     Citation Subset:  IM    
Affiliation:
The Lineberger Comprehensive Cancer Center, Department of Dermatology, University of North Carolina at Chapel Hill, 130 Manning Dr, CB 7305, Chapel Hill, NC 27516, USA. pdillon@unch.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Azathioprine / adverse effects*
Head and Neck Neoplasms / chemically induced,  drug therapy,  secondary
Humans
Immunosuppression
Immunosuppressive Agents / adverse effects*
Lung Neoplasms / chemically induced,  drug therapy,  secondary
Male
Melanoma / chemically induced*,  drug therapy,  pathology
Middle Aged
Myasthenia Gravis / drug therapy*
Prognosis
Review Literature as Topic
Skin Neoplasms / chemically induced,  drug therapy,  secondary
Grant Support
ID/Acronym/Agency:
P01 ES014635/ES/NIEHS NIH HHS
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 446-86-6/Azathioprine
Comments/Corrections

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