monitoring for lymphoma while taking cellcept

[dutch4]

Should the transplant team/doctor monitor liver transplant patients taking cellcept post liver transplant over time?  Is there a significant threat of cellcept causing lymphoma?

[Thomas D Schiano, MD]

i agree with the above comments.  however, there is no documented increased cancer risk specifically with the use of long-term mycophenolate use.  the less immunosuppression one takes over time, the better however.

[gilmane]

As a liver transplant recipient myself, my advice is not to rely on your transplant team "Monitoring" as your first line of defense of cancer post transplant. Life after a liver transplant requires the recipient to be aware of the increased risk of infections and cancer. All immunosuppressants work by decreasing the activity of certain cells that make up part of the immune system to help reduce the risk of organ transplant rejection. CellCept weakens your immune system, which may decrease your ability to fight illness or infection. It may also increase the risk of certain types of cancer. Although almost all cancers can occur, skin cancer and non-Hodgkin’s lymphomas are the most frequent. Skin cancer of the non-melanomic variety, especially squamous cell cancer, is the most frequent of all cancers.  Its incidence increases as the duration of immunosuppression increases.  Although metastasis and death from these cancers are uncommon in the general population, they can be fatal in the transplant population.
All post transplant patients should be alert to the early detection of cancer. This can be helped by monthly breast, testicular and skin self examination and routine medical check-ups. PAP smears, breast exams, testicular exams, and skin cancer screening should be done by your physician every year. Other general measures should also be taken. These include:
• Reduce sun exposure
• Stop smoking
• Follow a balanced diet plan
• Get enough exercise

Life can be very good post transplant, but you must work on being aware of those things that increase your risk of serious illness. Your transplant team can help identify these, but it becomes your job to follow-up on them, especially as time goes on. With luck you will be seeing less and less of your transplant team and more follow-up is with your own physician. You went through a lot to get the transplant, now is not the time to become complacent.