TY - JOUR
T1 - Clinicopathological features, MCPyV status and outcomes of Merkel cell carcinoma in solid-organ transplant recipients: a retrospective, multicentre cohort study
AU - Ferrandiz Pulido, Carla
AU - Gómez-Tomás, Álvaro
AU - Llombart, B.
AU - Mendoza, D.
AU - Marcoval, J
AU - Piaserico, S.
AU - Baykal, C.
AU - Bouwes-Bavinck, J.N.
AU - Rácz, E.
AU - Kanitakis, J.
AU - Harwood, C.A.
AU - Cetkovská, P.
AU - Geusau, A.
AU - Del Marmol, V.
AU - Masferrer, E.
AU - Orte Cano, C.
AU - Ricar, J.
AU - Oliveira, W.R. de
AU - Salido Vallejo, R.
AU - Ducroux, E.
AU - Gkini, M.A.
AU - López Guerrero, J.A.
AU - Kutzner, H.
AU - Kempf, W.
AU - Seçkin, D.
N1 - © 2022 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
PY - 2022/11
Y1 - 2022/11
N2 - BACKGROUND: The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes.OBJECTIVE: To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes.METHODS: Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction.RESULTS: A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR.LIMITATIONS: Retrospective design and heterogeneity of SOTR cohort.CONCLUSIONS: MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
AB - BACKGROUND: The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes.OBJECTIVE: To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes.METHODS: Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction.RESULTS: A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR.LIMITATIONS: Retrospective design and heterogeneity of SOTR cohort.CONCLUSIONS: MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
KW - Carcinoma, Merkel Cell/pathology
KW - Humans
KW - Merkel cell polyomavirus
KW - Organ Transplantation/adverse effects
KW - Polyomavirus Infections
KW - Retrospective Studies
KW - Skin Neoplasms/pathology
KW - TOR Serine-Threonine Kinases
KW - Tumor Virus Infections/complications
UR - https://www.scopus.com/pages/publications/85131727639
U2 - 10.1111/jdv.18256
DO - 10.1111/jdv.18256
M3 - Article
C2 - 35607918
SN - 0926-9959
VL - 36
SP - 1991
EP - 2001
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
IS - 11
ER -