Advanced donor-origin melanoma in a renal transplant recipient: immunotherapy, cure, and retransplantation

Transplantation. 1998 Sep 15;66(5):655-61. doi: 10.1097/00007890-199809150-00020.

Abstract

Background: A kidney transplant recipient inadvertently contracted donor-origin melanoma, which was found to be very advanced at presentation. Withdrawal of immunosuppression failed to induce rejection, and interferon-alpha was required. When florid allograft rejection was in progress, the allograft was removed, before it was recognized that the transplanted melanoma was not being simultaneously rejected.

Methods: Subsequent immunotherapy was required, which largely recapitulated treatment of recognized value in autologous melanoma and included interferon-alpha, use of cultured melanoma cells as tumor vaccine, pooled allogeneic cell vaccination, and adoptive immunotherapy using lymphokine-activated killer cells.

Results: Prolonged immunotherapy eradicated the widespread malignancy, and the patient went on to a successful second renal transplant, with follow-up of over 24 months.

Conclusions: This unique case demonstrates the successful cure of advanced transplanted melanoma through the use of immunotherapy, which did not require sophisticated tumor vaccine technology, and successful retransplantation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology
  • Male
  • Melanoma / immunology
  • Melanoma / pathology*
  • Middle Aged
  • Recombinant Proteins
  • Tissue Donors*
  • Transplantation Immunology*

Substances

  • Antineoplastic Agents
  • Immunosuppressive Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins