The following article features coverage from the NCCN 2022 Annual Conference. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Transplant recipients and patients with immunodeficiency disorders have a higher risk of cancer compared with the general population, according to a study presented at the NCCN 2022 Annual Conference.

The cancer incidence in these immunocompromised patients was almost twice as high as the age-adjusted cancer incidence in the general population.

“Transplant patients and patients with primary or secondary immunodeficiency may benefit from early cancer detection strategies [as] early detection of cancer has demonstrated the potential to increase survival and decrease the long-term cost,” said study author Sabrina Ilham, PharmD, of the University of Utah in Salt Lake City.

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Dr Ilham and colleagues conducted this retrospective study because prior studies linked immunodeficiency with an increased cancer risk, but specific risk factors remain unclear.

Patient Details

The study included 13,887 immunocompromised patients from the University of Utah Electronic Data Warehouse and the Huntsman Cancer Institute Tumor Registry.

The cohort included 2982 patients who had received a solid organ or hematopoietic stem cell transplant, 3363 who were treated with a tumor necrosis factor inhibitor (TNF-i) for at least 3 months, and 7542 who were diagnosed with primary immunodeficiency disorder (PID) or secondary immunodeficiency disorder (SID).

Patients were treated between July 1, 2000, and February 28, 2018. They were followed until cancer diagnosis, the last follow-up visit, death, or the end of the study period (February 28, 2020).

The median follow-up was 4.4 years for the TNF-i cohort, 5.5 years for the transplant recipients, and 6.2 years for the PID/SID cohort.


The cumulative incidence of new cancer was 8.82% in the TNF-i group, 11.47% in the transplant group, and 14.28% in the PID/SID group.

The most common cancers in the transplant cohort were gastrointestinal (14.3%), hematopoietic (12.4%), and skin (12.4%) cancers. Common cancers in the PID/SID cohort were hematopoietic (22.3%), gastrointestinal (16.8%), and skin (14.2%) cancers as well. Common cancers in the TNF-i cohort were reproductive system (17.4%) and breast (15.9%) cancers.

The cancer incidence rate in the transplant recipients and the PID/SID cohort was almost twice as high as the age-adjusted cancer incidence (4.02 cases per 1000 person years) in the region.

In a multivariate analysis, transplant recipients and PID/SID patients had a higher risk of cancer than patients in the TNF-i cohort. The adjusted hazard ratio was 1.55 (95% CI, 1.15-2.1; P =.0041) for the transplant recipients and 2.21 (95% CI, 1.7-2.86; P <.0001) for the PID/SID cohort.

Additional factors associated with an increased risk of cancer were older age (50 years or older), male sex, White race, presence of a renal cyst, and benign in-situ disease.

Disclosures: This research was supported by GRAIL, LLC, a subsidiary of Illumina, Inc. Some study authors declared affiliations with GRAIL. Please see the original reference for a full list of disclosures.

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Ilham S, Willis C, Kim K, et al. Cancer incidence in immunocompromised patients. Presented at NCCN 2022 Annual Conference; March 31 – April 2, 2022. Abstract EPR22-109.